Outcomes for hospitalized patients with idiopathic pulmonary fibrosis treated with antifibrotic medications
Autor: | Andrew H. Limper, Stephanie Payne, Lindsey R. Sangaralingham, Bryan T. Kelly, Viengneesee Thao, Timothy M. Dempsey, Nilay Shah, Teng Moua, T. Teague |
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Rok vydání: | 2021 |
Předmět: |
Male
Indoles medicine.medical_treatment law.invention Cohort Studies Idiopathic pulmonary fibrosis chemistry.chemical_compound Mechanical ventilation 0302 clinical medicine law Cause of Death 030212 general & internal medicine Aged 80 and over Anti-Inflammatory Agents Non-Steroidal Interstitial lung disease Pirfenidone Middle Aged Intensive care unit Hospitalization Treatment Outcome Cohort Female Nintedanib medicine.drug Pulmonary and Respiratory Medicine medicine.medical_specialty Antifibrotics Pyridones Diseases of the respiratory system 03 medical and health sciences Internal medicine medicine Humans Mortality Propensity Score Protein Kinase Inhibitors Aged RC705-779 business.industry Research medicine.disease United States Critical care Logistic Models 030228 respiratory system chemistry Propensity score matching business |
Zdroj: | BMC Pulmonary Medicine, Vol 21, Iss 1, Pp 1-14 (2021) BMC Pulmonary Medicine |
ISSN: | 1471-2466 |
Popis: | Background Idiopathic Pulmonary Fibrosis is a chronic, progressive interstitial lung disease for which there is no cure. However, lung function decline, hospitalizations, and mortality may be reduced with the use of the antifibrotic medications, nintedanib and pirfenidone. Historical outcomes for hospitalized patients with Idiopathic Pulmonary Fibrosis are grim; however there is a paucity of data since the approval of nintedanib and pirfenidone for treatment. In this study, we aimed to determine the effect of nintedanib and pirfenidone on mortality following respiratory-related hospitalizations, intensive care unit (ICU) admission, and mechanical ventilation. Methods Using a large U.S. insurance database, we created a one-to-one propensity score matched cohort of patients with idiopathic pulmonary fibrosis treated and untreated with an antifibrotic who underwent respiratory-related hospitalization between January 1, 2015 and December 31, 2018. Mortality was evaluated at 30 days and end of follow-up (up to 2 years). Subgroup analyses were performed for all patients receiving treatment in an ICU and those receiving invasive and non-invasive mechanical ventilation during the index hospitalization. Results Antifibrotics were not observed to effect utilization of mechanical ventilation or ICU treatment during the index admission or effect mortality at 30-days. If patients survived hospitalization, mortality was reduced in the treated cohort compared to the untreated cohort when followed up to two years (20.1% vs 47.8%). Conclusions Treatment with antifibrotic medications does not appear to directly improve 30-day mortality during or after respiratory-related hospitalizations. Post-hospital discharge, however, ongoing antifibrotic treatment was associated with improved long-term survival. |
Databáze: | OpenAIRE |
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