RT Journal Article SR Electronic T1 Rates of change in FEV1 and DLCO as potential indicators for mTOR inhibitor therapy in premenopausal lymphangioleiomyomatosis patients JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1702258 DO 10.1183/13993003.02258-2017 VO 51 IS 4 A1 Angelo M. Taveira-DaSilva A1 Patricia Julien-Williams A1 Amanda M. Jones A1 Mario Stylianou A1 Joel Moss YR 2018 UL http://erj.ersjournals.com/content/51/4/1702258.abstract AB The value of rates of change in forced expiratory volume in 1 s (FEV1) and diffusing capacity of the lung for carbon monoxide (DLCO) to predict disease progression, and initiation of mTOR (mechanistic target of rapamycin) inhibitor therapy has not been evaluated.In 84 premenopausal lymphangioleiomyomatosis patients, individual rates of change in FEV1 and DLCO and their 95% confidence intervals were used to derive subsequent lowest values of FEV1 and DLCO that would prompt initiation of sirolimus therapy. These treatment criteria were compared with a criterion based on FEV1 or DLCO ≤70% predicted. In 12 patients undergoing sirolimus therapy both methods for determining the optimal point for initiation of therapy were evaluated.27 and 35 patients who experienced greater than expected rates of change in FEV1 and DLCO, respectively, would have been excluded from therapy based on an FEV1 or DLCO >70% pred. 25 of the 84 patients were eventually treated, but only when FEV1 or DLCO were ≤70% pred. Applying such treatment criteria to 12 patients undergoing sirolimus therapy would have delayed treatment for many years.Premenopausal females in whom FEV1 or DLCO are declining at rates above the expected based on their individual rates of decline, should be considered for sirolimus therapy before the FEV1 or DLCO falls to ≤70% pred.Past rates of FEV1 or DLCO decline are indicators of future lung function loss and initiation of sirolimus therapy http://ow.ly/rnAe30iWEsn