Real-world impact of antifibrotics on prognosis in patients with progressive fibrosing interstitial lung disease
Authors' conclusion
This is the first real-world study to show that antifibrotics improve the FVC decline in PF-ILD. However, among patients with non-IPF, we found no significant difference in mortality between those with and without antifibrotics.
Study context
- Population
- Patients with ILD (January 2012 to July 2021) diagnosed with progressive fibrosing interstitial lung disease (PF-ILD): ≥10% fibrosis on high-resolution CT (HRCT), relative forced vital capacity (FVC) decline ≥10% or >5% to <10% with clinical deterioration or fibrosis progression over 2 years, %FVC ≥45%PF-ILD of 574 patients
- Participants
- 167 patients
- Exposure
- Antifibrotics vs no antifibrotics
- Outcome
- FVC changes and overall survival
Methodological detailsinverse probability weighting, statistical matching, generalised estimating equations
- Inverse probability weighting
- Statistical matching
- Generalised estimating equations
Main finding
As reported in the abstract
FVC decline
- Antifibrotics improved FVC decline in idiopathic pulmonary fibrosis (IPF) (n=64)
- p=0.002
- Antifibrotics improved FVC decline in non-IPF (n=103)
- p=0.05
- Inverse probability weighting (IPW): IPF
- p=0.015
- IPW: non-IPF
- p=0.031
Observational data: associations, not effects.
Further findings
Overall survival
- IPF: Overall survival (OS) longer with antifibrotics
- log-rank p=0.001
- Non-IPF: OS not longer with antifibrotics
- P = 0.3263
- IPW: IPF
- P = 0.0534
- Statistical matching: IPF
- P = 0.0018
- IPW: non-IPF
- P = 0.5663
- Statistical matching: non-IPF
- P = 0.5618
Original publication
Real-world impact of antifibrotics on prognosis in patients with progressive fibrosing interstitial lung disease. RMD Open. Published 23 January 2023. doi:10.
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