The Impact of Switching to a Second Antifibrotic in Patients With Idiopathic Pulmonary Fibrosis: A Retrospective Multicentre Study From the EMPIRE Registry.

Autor:	Gregor J; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Adir Y; Carmel Medical Center, Haifa, Israel., Šterclová M; Department of Respiratory Medicine, Thomayer University Hospital, Prague, Czech Republic., Mogulkoc N; Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey., Kramer MR; Rabin Medical Centre, Petah Tikva, Israel., Doubková M; Department of Pulmonary Diseases and Tuberculosis, Faculty of Medicine, Masaryk University and University Hospital Brno, Czech Republic., Plačková M; Department of Pneumology, University Hospital Ostrava, Czech Republic., Müller V; Department of Pulmonology, Faculty of Medicine, Semmelweis University, Budapest, Hungary., Studnicka M; Department of Respiratory Medicine, Paracelsus Medical University Salzburg, Austria., Žurková M; Department of Respiratory Medicine, University Hospital Olomouc, Czech Republic., Lacina L; Department of Pneumology and Thoracic Surgery, Hospital Na Bulovce, Prague, Czech Republic., Lewandowska K; First Department of Pulmonary Diseases, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland., Bartoš V; Department of Pneumology, University Hospital Hradec Králové, Czech Republic., Ovesná P; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Májek O; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Koziar Vašáková M; Department of Respiratory Medicine, Thomayer University Hospital, Prague, Czech Republic. Electronic address: martina.koziarvasakova@ftn.cz.
Jazyk:	English; Spanish; Castilian
Zdroj:	Archivos de bronconeumologia [Arch Bronconeumol] 2024 Feb; Vol. 60 (2), pp. 80-87. Date of Electronic Publication: 2023 Dec 18.
DOI:	10.1016/j.arbres.2023.12.002
Abstrakt:	Introduction: Most patients with idiopathic pulmonary fibrosis (IPF) treated with antifibrotics (AF) have progressive disease despite treatment. A switch of AF may improve survival, but evidence from randomised controlled trials is missing. We aimed to evaluate the efficacy of an AF switch on survival and FVC decline in patients from the European MultiPartner IPF registry (EMPIRE). Methods: The study included 612 patients who discontinued the first antifibrotic therapy. Patients were grouped and analysed from two perspectives: (1) whether they had received a second antifibrotic treatment after the discontinuation of the first therapy, and (2) a reason for discontinuation of the first AF - "lack of efficacy" (LE) and "intolerance" (INT). Results: While 263 (43%) of 612 patients received no second AF ("non-switched"), 349 (57%) patients switched. Overall survival was higher in patients who received a second AF (median 50 vs. 29 months; adjusted HR 0.64, P=0.023). Similarly, the annual FVC decline was significantly reduced in switched patients: -98ml/y in switched and -172ml/y in non-switched patients (P=0.023), respectively. The switched patients had similar risk for mortality in both LE and INT groups (adjusted HR 0.95, P=0.85). The high impact of switching on survival was demonstrated in LE patients (adjusted HR 0.27, P<0.001). Conclusion: The patients without a second AF had significantly shorter overall survival. Our analysis suggests the importance of switching patients with an ineffective first AF therapy to a second AF therapy. (Copyright © 2023 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu