0:01

So why is UIP the 800 pound gorilla?

0:04

Why did we start with that in our practical approach?

0:08

Well, number one, it's gonna be the most common pattern

0:12

that we see in most centers.

0:13

So most cases of UIP being an imaging

0:18

and histological pattern, right?

0:19

So UIP is not a diagnosis, you know, UIP being usual,

0:23

interstitial pneumonia.

0:24

It's a pattern that we see,

0:26

but it's most strongly correlated with a clinical diagnosis

0:29

of idiopathic pulmonary fibrosis.

0:32

So, bottom line, we don't know what causes it.

0:34

As you guys know, idiopathic pulmonary

0:36

fibrosis is a bad player.

0:37

A lot of these patients, um, have very shortened survival.

0:41

And so it is really imperative

0:43

that we diagnose these earlier than later

0:45

so the patients can start

0:47

to get the appropriate therapy that they need.

0:50

So, because UIP is associated with IPF

0:53

and IPF is the most common well-defined clinical diagnosis

0:56

that we see at most centers, at least in the United States,

0:59

UIP is gonna be most common pattern

1:01

that we see in most centers.

1:03

Okay? It's just that, that sort of transitive relationship.

1:07

And so if you open up an H-R-C-T-N,

1:10

don't know the diagnosis, chances are well over 50%

1:14

of time the pattern will be some type of UIP.

1:16

It will be either typical UIP, so a very,

1:18

very high confidence pattern, UIP or a probable UIP pattern.

1:22

And we'll go into the difference between a typical UIP

1:25

and a probable UIP pattern in just a bit.

1:28

Secondly, why we use this UIP centric approach is

1:31

because UIP is a bad player.

1:34

I mentioned before that UIP associated

1:36

with IPF idiopathic pulmonary fibrosis,

1:39

and patients with IPF don't do well.

1:41

They have worse prognosis than many

1:42

other types of lung disease.

1:44

But overall, even outside the setting of IPF,

1:47

if you have any type of pulmonary fibrosis

1:51

or interstitial lung disease

1:52

and you have a UIP pattern, you tend not to do as well

1:57

as if you didn't have a UIP pattern.

1:59

There are some outliers out there, some disease settings

2:02

where maybe there isn't as much of a difference.

2:04

But I think that if you just want to simplify these things,

2:07

and I think for the purposes of this talk,

2:10

probably it is best to just simplify it.

2:11

If you have UIP,

2:13

it means worse prognosis than if you don't have UIP.

2:16

And that's why we use the UIP centric approach.

2:18

That's why UIP is the 800 pound gorilla

2:21

because it's gonna be the most common pattern that we see,

2:24

at least as a plurality, but some places as a majority.

2:27

And it's gonna be the most mortal pattern that we see,

2:30

and that's why we see it.