Antifibrotic therapy may confer survival advantage in patients with idiopathic pulmonary fibrosis

The use of antifibrotic therapy in patients with idiopathic pulmonary fibrosis (IPF) has the potential to improve survival outcome, as reported in a study.

For the study, data from a multicentre US registry of patients with IPF were used to evaluate the impact of antifibrotic therapy (nintedanib or pirfenidone) on outcomes such as death, death or lung transplant, respiratory-related hospitalization, and acute worsening of IPF (defined as any healthcare encounter deemed due to acute worsening of IPF).

The analysis included 499 patients, among whom 352 (70.5 percent) received antifibrotic therapy, with the median therapy exposure being 21.5 months.

At baseline, treated vs untreated patients were younger (70 vs 73 years), had higher body mass index (29.4 vs 28.0 kg/m²), had more recent symptom onset (12.8 vs 21.2 months), were more likely to have had a lung biopsy (27 percent vs 11 percent), and were more likely to have a definite diagnosis of IPF (66 percent vs 56 percent), a history of obstructive sleep apnoea (28 percent vs 19 percent), inspiratory crackles (82 percent vs 70 percent), or a family history of interstitial lung disease (20 percent vs 13 percent).

Compared with untreated patients, treated patients had lower estimated event rates of death at 1 year (6.6 percent, 95 percent confidence interval [CI], 6.1–7.1 vs 10.2 percent, 95 percent CI, 9.5–10.9).

Treatment was associated with a marked reduction in the risk of death (hazard ratio [HR], 0.53, 95 percent CI, 0.28–1.03; p=0.060), as well as numerical increases in risks of respiratory-related hospitalization (HR, 1.88, 95 percent CI, 0.90–3.92; p=0.091) and acute worsening of IPF (HR, 1.71, 95 percent CI, 0.36–8.09; p=0.496).