Antireflux drug not as beneficial in idiopathic pulmonary fibrosis treatment

While gastroesophageal reflux disease is a common comorbidity in idiopathic pulmonary fibrosis (IPF), treatment with a proton pump inhibitor (PPI) does not appear to have any bearing on mortality and hospitalization outcomes among IPF patients, according to real-world data.

Researchers looked at 3,036 patients, of whom 1,917 (63 percent) received a PPI prescription after IPF diagnosis (mean, 7.8 months). They used propensity scoring to match 1,852 patients prescribed PPIs post-IPF diagnosis and 1,852 non-PPI users to assess whether the antireflux drug conferred benefits for all-cause mortality, respiratory-related mortality, and respiratory-related hospitalization.

There were 1,221 deaths (67 percent related to respiratory causes) recorded in the PPI group over a mean follow up of 2.4 years and 482 deaths (67 percent related to respiratory causes) in the non-PPI group over mean 1.1 years of follow-up. The corresponding incidence rates of death from any cause were 27.8 and 24.3 per 100 per year.

In multivariable Cox models, the use of PPIs did not improve survival among IPF patients compared with nonuse. The hazard ratios were 1.07 (95 percent confidence interval [CI], 0.94–1.22) for all-cause mortality, 1.10 (95 percent CI, 0.94–1.28) for respiratory-related mortality, and 1.00 (95 percent CI, 0.86–1.16) for respiratory-related hospitalizations.

Sensitivity analyses showed similar results.

The findings indicate that PPIs may not be as beneficial in the treatment of IPF, contrary to what has been suggested in some studies and conditionally recommended in treatment guidelines, the researchers said.