ArticleChest2013
Identifying an inciting antigen is associated with improved survival in patients with chronic hypersensitivity pneumonitis.
Article in Chest, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 161 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
161 citing papers in PubMed, 5 syntheses or guidelines pooled it, 389 citations in OpenAlex.
- Diagnosis and Treatment of Hypersensitivity Pneumonitis: S2k Guideline of the German Respiratory Society and the German Society for Allergology and Clinical Immunology.Respiration; international review of thoracic diseases · 2025Guideline
- Guidelines of the Polish Respiratory Society on the Diagnosis and Treatment of Progressive Fibrosing Interstitial Lung Diseases Other than Idiopathic Pulmonary Fibrosis.Advances in respiratory medicine · 2022Guideline
- Occupational causes of hypersensitivity pneumonitis: a systematic review and compendium.Occupational medicine (Oxford, England) · 2021Pooled it
- Diagnosis of Hypersensitivity Pneumonitis in Adults. An Official ATS/JRS/ALAT Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2020Guideline
- A Systematically Derived Exposure Assessment Instrument for Chronic Hypersensitivity Pneumonitis.Chest · 2020Pooled it
- Shared and Disease-Preferential Matrisome Programs in Fibrosing Interstitial Lung Disease: Evidence from Cross-Cohort and Within-Cohort Analysis.Current issues in molecular biology · 2026Article
- Diagnostic, prognostic, and therapeutic challenges in patients with hypersensitivity pneumonitis.ERJ open research · 2026Review
- Plasma proteomics and machine learning deliver non-invasive distinction between fibrotic hypersensitivity pneumonitis and idiopathic pulmonary fibrosis.Journal of translational medicine · 2026Article
- Prognostic value of ventilatory efficiency in hypersensitivity pneumonitis.BMJ open respiratory research · 2026Article
- Prevalence and Prognostic Impact of Progressive Pulmonary Fibrosis.Tuberculosis and respiratory diseases · 2026Review
- Dual pathology, dual burden: Functional impact of emphysema and fibrosis in Hypersensitivity Pneumonitis.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2026Article
- Severe Occupational Hypersensitivity Pneumonitis: A Case Series of Four Patients Requiring Lung Transplantation.American journal of industrial medicine · 2026Article
- Current concepts in the diagnosis and treatment of hypersensitivity pneumonitis: a narrative review.Respiratory research & clinical practice · 2026Review
- Fibrotic Patterns and Diagnostic Correlates in Hypersensitivity Pneumonitis: Clinical, Radiologic, and Hematologic Insights.Diagnostics (Basel, Switzerland) · 2025Article
- Efficacy of pirfenidone in fibrotic hypersensitivity pneumonitis: a systematic review and meta-analysis of randomized controlled trials.Annals of medicine and surgery (2012) · 2025Article
- [What is certain in the treatment of interstitial lung diseases?]Innere Medizin (Heidelberg, Germany) · 2025Review
- Survey of physicians' approaches to the clinical evaluation of interstitial lung disease in Singapore (SoPhoCLES).Journal of thoracic disease · 2025Article
- Baseline and Change in Peripheral Blood Transcriptome Enhance Outcome Prediction in Fibrotic Hypersensitivity Pneumonitis: A Prospective Multicenter Cohort Study.medRxiv : the preprint server for health sciences · 2025Article
- Quality of life in patients with hypersensitivity pneumonitis and with idiopathic pulmonary fibrosis in real-life clinical practice.Journal of thoracic disease · 2025Article
- Prognostic Impact of Quantitative CT Disease Extent and Pattern in Hypersensitivity Pneumonitis.medRxiv : the preprint server for health sciences · 2025Article
101 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe cornerstone of hypersensitivity pneumonitis (HP) management is having patients avoid the inciting antigen (IA). Often, despite an exhaustive search, an IA cannot be found. The objective of this study was to examine whether identifying the IA impacts survival in patients with chronic HP.
methodsWe used the Kaplan-Meier method to display, and the log-rank test to compare, survival curves of patients with well-characterized chronic HP stratified on identification of an IA exposure. A Cox proportional hazards (PH) model was used to identify independent predictors in time-to-death analysis.
resultsOf 142 patients, 67 (47%) had an identified IA, and 75 (53%) had an unidentified IA. Compared with survivors, patients who died (n = 80, 56%) were older, more likely to have smoked, had lower total lung capacity % predicted and FVC % predicted, had higher severity of dyspnea, were more likely to have pulmonary fibrosis, and were less likely to have an identifiable IA. In a Cox PH model, the inability to identify an IA (hazard ratio [HR], 1.76; 95% CI, 1.01-3.07), older age (HR, 1.04; 95% CI, 1.01-1.07), the presences of pulmonary fibrosis (HR, 2.43; 95% CI, 1.36-4.35), a lower FVC% (HR, 1.36; 95% CI, 1.10-1.68), and a history of smoking (HR, 2.01; 95% C1, 1.15-3.50) were independent predictors of shorter survival. After adjusting for mean age, presence of fibrosis, mean FVC%, mean diffusing capacity of the lung for carbon monoxide (%), and history of smoking, survival was longer for patients with an identified IA exposure than those with an unidentified IA exposure (median, 8.75 years vs 4.88 years; P = .047).
conclusionsAmong patients with chronic HP, when adjusting for a number of potentially influential predictors, including the presence of fibrosis, the inability to identify an IA was independently associated with shortened survival.
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