Prevent sarcopaenia, preserve lung function in IPF patients, says study

Skeletal muscle loss is observed in patients with idiopathic pulmonary fibrosis (IPF) receiving antifibrotic therapy, but without obvious weight loss, results of a study have shown.

“These patients mostly died by chronic respiratory failure, and skeletal muscle wasting has prognostic significance, suggesting that preventing sarcopaenia as well as preserving lung function are important for managing these patients,” the authors said.

This study included two cohorts of patients with IPF on antifibrotic therapy, a historical cohort of IPF patients not on antifibrotic therapy, and controls. The cause of mortality was compared with a historical cohort. Finally, the authors assessed sarcopaenia by measuring the cross-sectional area of the erector spinae muscle (ESMCSA) and muscle attenuation of the ESM (ESMMA) via computed tomography.

IPF patients had smaller ESMCSA and lower ESMMA than controls, but body mass index (BMI) was similar. This finding suggested that IPF patients had skeletal muscle loss without any obvious body weight loss.

Chronic respiratory failure was the most common cause of mortality in IPF patients receiving antifibrotic therapy, which accounted for approximately 60 percent. There were also decreased proportions of lung cancer seen.

Furthermore, low ESMCSA was found to be an independent prognostic factor associated with worse survival rates. Clear prognostic distinction was provided by the combined assessment of ESMCSA, %FVC predicted, and BMI values.

“Recent research has highlighted the fundamental role of sarcopaenia, characterized by loss of skeletal muscle mass and strength, with a risk of poor outcomes,” the authors said. “Antifibrotic therapy preserves lung function by preventing the annual decline in FVC and is associated with improved outcomes in patients with IPF.”