Improved Survival of IPF patients Treated With Antifibrotic Drugs Compared With Untreated Patients.

Autor: Platenburg MGJP; Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435CM, The Netherlands. m.platenburg@antoniusziekenhuis.nl., van Moorsel CHM; Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435CM, The Netherlands.; Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands., Wiertz IA; Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435CM, The Netherlands., van der Vis JJ; Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435CM, The Netherlands.; Department of Clinical Chemistry, St Antonius Hospital, Nieuwegein, The Netherlands., Vorselaars ADM; Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435CM, The Netherlands.; Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands., Veltkamp M; Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435CM, The Netherlands.; Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands., Grutters JC; Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435CM, The Netherlands.; Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Lung [Lung] 2023 Aug; Vol. 201 (4), pp. 335-343. Date of Electronic Publication: 2023 Jun 21.
DOI: 10.1007/s00408-023-00628-4
Abstrakt: Purpose: Pirfenidone and nintedanib unequivocally inhibit FVC decline, but have been inconsistently linked to reduced mortality in phase III studies. On the contrary, real-world data show a survival benefit of antifibrotic drugs. However, it is unknown what this benefit is across different Gender, Age, and Physiology (GAP) stages.
Research Questions: Is there a difference in transplant-free (TPF) survival of IPF patients receiving antifibrotic drugs (IPF AF ) compared with an untreated cohort (IPF non-AF )? Is this different for patients with GAP stage I, II, or III.
Methods: This is a single-center observational cohort study using prospectively included patients diagnosed with IPF between 2008-2018. Primary outcomes were TPF survival difference and 1-, 2-, and 3-year cumulative mortality for IPF AF and IPF non-AF . This was repeated after stratification for GAP stage.
Results: In total, 457 patients were included. The median transplant-free survival was 3.4 years in IPF AF (n = 313) and 2.2 years in IPF non-AF (n = 144, p = 0.005). For GAP stage II, a median survival of 3.1 and 1.7 years was noted for IPF AF (n = 143) and IPF non-AF (n = 59, p < 0.001), respectively. A significantly lower 1-, 2-, and 3- year cumulative mortality was found for IPF AF with GAP stage II (1 yr: 7.0% vs 35.6%, 2 yr: 26.6% vs 55.9%, and 3 yr: 46.9% vs 69.5%). The 1-year cumulative mortality of IPF AF with GAP III was also significantly lower (19.0% vs 65.0%).
Conclusion: This large real-world study showed a survival benefit in IPF AF compared with IPF non-AF . This especially holds true for patients with GAP stage II and III.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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