Rishi Raj

All Publications

• Predictors of death or lung transplant after a diagnosis of idiopathic pulmonary fibrosis: insights from the IPF-PRO Registry RESPIRATORY RESEARCH Snyder, L., Neely, M. L., Hellkamp, A. S., O'Brien, E., de Andrade, J., Conoscenti, C. S., Leonard, T., Bender, S., Gulati, M., Culver, D. A., Kaner, R. J., Palmer, S., Kim, H., Asi, W., Baker, A., Beegle, S., Belperio, J. A., Condos, R., Cordova, F., Culver, D. A., de Andrade, J. M., Dilling, D., Flaherty, K., Glassberg, M., Gulati, M., Guntupalli, K., Gupta, N., Case, A., Hotchkin, D., Huie, T., Kaner, R., Kim, H., Kreider, M., Lancaster, L., Lasky, J., Lederer, D., Lee, D., Liesching, T., Lipchik, R., Lobo, J., Mageto, Y., Menon, P., Morrison, L., Namen, A., Oldham, J., Raj, R., Ramaswamy, M., Russell, T., Sachs, P., Safdar, Z., Sigal, B., Silhan, L., Strek, M., Suliman, S., Tabak, J., Walia, R., Whelan, T. P., IPF-PRO Registry Investigators 2019; 20: 105

  Abstract

  Idiopathic pulmonary fibrosis (IPF) is a progressive disease with a variable clinical course and high mortality. We used data from a large national US registry of patients with IPF to investigate relationships between patient characteristics, including markers of disease severity, and mortality.The analysis cohort comprised patients enrolled in the IPF-PRO Registry from its inception on 5 June 2014 to 26 October 2017. The primary criterion for inclusion in this registry is that patients must be diagnosed or confirmed with IPF at the enrolling centre within 6 months. Associations between patient characteristics and markers of disease severity at enrolment and mortality outcomes were investigated using univariable, multivariable and adjustment models.Among 662 patients enrolled, 111 patients died or had a lung transplant over a follow-up period of 30 months. The probability of being free of both events at month 30 was 50.6% (95% CI: 40.0, 60.2). When patient characteristics and markers of disease severity were jointly examined in a multivariable analysis, oxygen use at rest (hazard ratio [HR] 2.44 [95% CI: 1.45, 4.10]), lower forced vital capacity (FVC) % predicted (HR 1.28 [95% CI: 1.10, 1.49] per 10% decrease) and diffusion capacity for carbon monoxide (DLco) % predicted (HR 1.25 [95% CI: 1.04, 1.51] per 10% decrease) were significantly associated with increased risk of death or lung transplant. The risk of death or lung transplant increased with increasing age in patients ≥62 years old (HR 1.18 [95% CI: 0.99, 1.40] per 5-year increase), and decreased with increasing age in patients <62 years old (HR 0.60 [95% CI: 0.39, 0.92] per 5-year increase).In an observational US registry of patients with IPF, oxygen use at rest, lower FVC % predicted, and lower DLco % predicted were associated with risk of death or lung transplant. An audio podcast of the lead author discussing these data can be downloaded from: http://www.usscicomms.com/respiratory/snyder/IPF-PROsurvival1/ .ClinicalTrials.gov number: NCT01915511 .

  View details for DOI 10.1186/s12931-019-1043-9

  View details for Web of Science ID 000469504900001

  View details for PubMedID 31142314

  View details for PubMedCentralID PMC6542049

• Tissue Continues to Be the Issue: Role of Histopathology in the Context of Recent Updates in the Radiologic Classification of Interstitial Lung Diseases. Archives of pathology & laboratory medicine Raparia, K., Raj, R. 2019; 143 (1): 30–33

  Abstract

  High-resolution computed tomography (HRCT) imaging has an increasingly important role in clinical decision-making in patients with interstitial lung diseases. The recent Fleischner Society white paper on the diagnostic criteria for idiopathic pulmonary fibrosis highlights the advances in our understanding of HRCT imaging in interstitial lung diseases.To discuss the evidence and recommendations outlined in the white paper as it pertains to the radiologic diagnosis of interstitial lung disease, specifically highlighting the current limitations of HRCT in confidently predicting histopathologic findings.The recent Fleischner Society white paper and other studies pertaining to the role of HRCT in predicting histopathology in interstitial lung diseases are reviewed.High-resolution computed tomography is highly predictive of a usual interstitial pneumonia (UIP) pattern on histopathology when the HRCT shows a typical UIP pattern on a "confident" read by the radiologist. A probable UIP pattern is also very predictive of a UIP pattern on histopathology, and histopathologic confirmation is not needed for most patients demonstrating this pattern in the appropriate clinical setting. A UIP pattern may be seen in a substantial proportion of patients with an "indeterminate UIP" pattern on HRCT and in many patients for whom the HRCT suggests an alternative diagnosis; histopathologic confirmation should be considered in patients demonstrating these patterns whenever feasible.

  View details for PubMedID 30785335

• Tissue Continues to Be the Issue Role of Histopathology in the Context of Recent Updates in the Radiologic Classification of Interstitial Lung Diseases ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE Raparia, K., Raj, R. 2019; 143 (1): 30–33

  View details for DOI 10.5858/arpa.2018-0134-RA

  View details for Web of Science ID 000454121800005

• Rituximab Versus Mycophenolate Mofetil in Interstitial Lung Disease Secondary to Connective Tissue Disease Zhu, L., Li, S., Gagne, L., Jacobs, S., Morisset, J., Mooney, J., Raj, R., Chung, L. WILEY. 2018

  View details for Web of Science ID 000447268902402