Antifibrotics tied to earlier wall dehiscence after lung transplant

Patients on antifibrotics experience chest wall dehiscence earlier than those who did not receive antifibrotic treatment following lung transplantation, reveals a recent study, noting that this factor does not significantly influence survival.

“Antifibrotic drugs are the standard treatments for patients with IPF,” the authors said.

A total of 164 patients diagnosed with idiopathic pulmonary fibrosis (IPF) who underwent a lung transplantation between January 2015 and June 2019 at four Spanish hospitals were retrospectively recruited. Cases referred to those receiving antifibrotic treatment at time of transplant. Each case was matched with a control who were not on antifibrotics. Of the patients, 103 were cases and 61 controls.

No statistically significant between-group differences were observed in any of the items analysed linked to transplantation, except for the time until the appearance of chest wall dehiscence. No differences were noted in the incidence of wall dehiscence in either group (12.3 percent vs 13.7 percent; p=0.318), but patients on antifibrotic drugs had it earlier (21 vs 63 days; p=0.012).

Of note, no differences were seen in overall post-transplant survival between cases and controls (p=0.698) or in conditional survival at 30 days, 90 days, 3 years, and 5 years. However, control participants had significantly greater survival at 1 year than those on antifibrotic treatment (93.3 percent vs 80.6 percent; p=0.028).

“There was evidence that chest wall dehiscences appeared earlier post-transplant in patients using antifibrotics, even though this factor did not significantly impact survival,” the authors said.