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. 2021 Dec 24:8:802989.
doi: 10.3389/fmed.2021.802989. eCollection 2021.

Mortality and Respiratory-Related Hospitalizations in Idiopathic Pulmonary Fibrosis Not Treated With Antifibrotics

Vincent Cottin  1 , Paolo Spagnolo  2 , Philippe Bonniaud  3   4 , Maëva Nolin  5 , Faustine Dalon  5 , Klaus-Uwe Kirchgässler  6 , Tripthi V Kamath  7 , Eric Van Ganse  5   8 , Manon Belhassen  5
Affiliations

Mortality and Respiratory-Related Hospitalizations in Idiopathic Pulmonary Fibrosis Not Treated With Antifibrotics

Vincent Cottin et al. Front Med (Lausanne). .

Abstract

Background: Real-world data regarding outcomes of idiopathic pulmonary fibrosis (IPF) are scarce, outside of registries. The claims data from the French National Health System (SNDS) were used to describe outcomes in patients diagnosed with IPF in 2015-2016 but who did not receive antifibrotic therapies. Method: Patients aged <50 years were excluded, as were patients with pulmonary fibrosis other than IPF, patients who had previously received a lung transplant, and those who had received antifibrotic therapies at any time between 2010 and 2016. Patients were followed-up until their last health record, lung transplantation, initiation of antifibrotic therapies, death, or the end of the study period (31 December 2017), whichever occurred first. Results: A total of 5,360 patients (43.2%) not treated with antifibrotic therapies were included. The mean age was 75.5 years, and 57.9% were males. In the year before inclusion, 47.3% of patients had a Charlson score ≥5. During follow-up, 41.2% of patients died. The unadjusted incidence rate was 29.9 per 100 person-years (95%CI = [28.7-31.2]), and the cumulative incidence of death at 3 years was 50.2% (95% CI = [48.3-52.1%]). In the study population, 35.3% of patients experienced an acute respiratory-related hospitalization. The unadjusted incidence rate was 32.1 per 100 person-years (95%CI = [30.6-33.5]) and the cumulative incidence of the event at 3 years was 41.5% (95% CI = [39.7-43.2%]). Interpretation: This observational study showed that, if untreated with antifibrotics, IPF is associated with a 50% all-cause mortality at 3 years. These figures can serve as a historical control of the natural course of the disease.

Keywords: acute hospitalizations; antifibrotics; claims data; idiopathic pulmonary fibrosis; mortality.

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Conflict of interest statement

FD, MN, and MB are full-time employees of PELyon. EVG is the scientific advisor of PELyon. VC reports personal fees and non-financial support from Actelion, Bayer/MSD, and Roche; grants, personal fees, and non-financial support from Boehringer Ingelheim; personal fees from Novartis, Sanofi, Promedior, Celgene, Galapagos, and Galecto, outside the submitted work. PS reports institutional grants, consulting fees, and non-financial support from PPM Services; institutional grants, personal fees, and non-financial support from Roche and Boehringer Ingelheim; personal fees from Chiesi, Galapagos, Lupin, Pieris, and REDX Pharma, outside the submitted work. K-UK is an employee and shareholder of F. Hoffmann-La Roche, Ltd. PB reports personal fees and non-financial support from Roche, Boehringer Ingelheim, Novartis, Sanofi, Chiesi, AstraZeneca, Stallergenes, and GSK, outside the submitted work. TK is a full-time employee at Janssen Pharmaceuticals. The reviewer NB declared a shared affiliation with one of the author PS, to the handling editor at time of review.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Cumulative incidence curve of (A) all-cause mortality and (B) acute respiratory-related hospitalization for untreated IPF patients.
See this image and copyright information in PMC

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