Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis
Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease (ILD). Currently, two antifibrotic drugs are available for reducing forced vital capacity (FVC) decline in IPF. However, many pulmonologists wait before initiating treatment, especially when IPF pati...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-09-01
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| Series: | Therapeutic Advances in Respiratory Disease |
| Online Access: | https://doi.org/10.1177/1753466620953783 |
| _version_ | 1818302698747854848 |
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| author | Yuya Aono Yutaro Nakamura Masato Kono Hidenori Nakamura Koshi Yokomura Shiro Imokawa Mikio Toyoshima Hideki Yasui Hironao Hozumi Masato Karayama Yuzo Suzuki Kazuki Furuhashi Noriyuki Enomoto Tomoyuki Fujisawa Naoki Inui Takafumi Suda |
| author_facet | Yuya Aono Yutaro Nakamura Masato Kono Hidenori Nakamura Koshi Yokomura Shiro Imokawa Mikio Toyoshima Hideki Yasui Hironao Hozumi Masato Karayama Yuzo Suzuki Kazuki Furuhashi Noriyuki Enomoto Tomoyuki Fujisawa Naoki Inui Takafumi Suda |
| author_sort | Yuya Aono |
| collection | DOAJ |
| description | Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease (ILD). Currently, two antifibrotic drugs are available for reducing forced vital capacity (FVC) decline in IPF. However, many pulmonologists wait before initiating treatment, especially when IPF patients have stable disease. This study aimed to investigate the impact on survival outcome of FVC decline and a slow rate of FVC decline prior to and following treatment with these two antifibrotic drugs. Methods: Out of the 235 IPF patients treated with antifibrotic therapy that were screened, 105 cases were eligible, who then underwent physiological evaluation at 6 months prior to and following antifibrotic therapy. Clinical characteristics and prognostic outcomes were compared among groups, and prognostic factors were evaluated using a Cox proportional hazards analysis. Results: In terms of %FVC decline prior to the therapy and a slow rate of FVC decline, there was no significant difference between stable and worsened groups and responder and non-responder groups, respectively. On the other hand, in terms of %FVC decline (decline >5%) following antifibrotic therapy, the stable/improved group had significantly better prognosis than the worsened group. Prognostic analysis revealed that a stable/improved status following antifibrotic therapy [HR: 0.35 (0.15–0.87)] was significantly associated with a better prognosis. Conclusions: Concerning the FVC decline prior to and following antifibrotic therapy and a slow rate of FVC decline, only the FVC decline following the therapy is associated with a greater survival outcome. An early treatment decision may thus be beneficial for IPF. The reviews of this paper are available via the supplemental material section. |
| first_indexed | 2024-12-13T05:43:03Z |
| format | Article |
| id | doaj.art-40c21df7cfa044998f4e9b75e870075d |
| institution | Directory Open Access Journal |
| issn | 1753-4666 |
| language | English |
| last_indexed | 2024-12-13T05:43:03Z |
| publishDate | 2020-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Respiratory Disease |
| spelling | doaj.art-40c21df7cfa044998f4e9b75e870075d2022-12-21T23:57:45ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662020-09-011410.1177/1753466620953783Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosisYuya AonoYutaro NakamuraMasato KonoHidenori NakamuraKoshi YokomuraShiro ImokawaMikio ToyoshimaHideki YasuiHironao HozumiMasato KarayamaYuzo SuzukiKazuki FuruhashiNoriyuki EnomotoTomoyuki FujisawaNaoki InuiTakafumi SudaBackground: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease (ILD). Currently, two antifibrotic drugs are available for reducing forced vital capacity (FVC) decline in IPF. However, many pulmonologists wait before initiating treatment, especially when IPF patients have stable disease. This study aimed to investigate the impact on survival outcome of FVC decline and a slow rate of FVC decline prior to and following treatment with these two antifibrotic drugs. Methods: Out of the 235 IPF patients treated with antifibrotic therapy that were screened, 105 cases were eligible, who then underwent physiological evaluation at 6 months prior to and following antifibrotic therapy. Clinical characteristics and prognostic outcomes were compared among groups, and prognostic factors were evaluated using a Cox proportional hazards analysis. Results: In terms of %FVC decline prior to the therapy and a slow rate of FVC decline, there was no significant difference between stable and worsened groups and responder and non-responder groups, respectively. On the other hand, in terms of %FVC decline (decline >5%) following antifibrotic therapy, the stable/improved group had significantly better prognosis than the worsened group. Prognostic analysis revealed that a stable/improved status following antifibrotic therapy [HR: 0.35 (0.15–0.87)] was significantly associated with a better prognosis. Conclusions: Concerning the FVC decline prior to and following antifibrotic therapy and a slow rate of FVC decline, only the FVC decline following the therapy is associated with a greater survival outcome. An early treatment decision may thus be beneficial for IPF. The reviews of this paper are available via the supplemental material section.https://doi.org/10.1177/1753466620953783 |
| spellingShingle | Yuya Aono Yutaro Nakamura Masato Kono Hidenori Nakamura Koshi Yokomura Shiro Imokawa Mikio Toyoshima Hideki Yasui Hironao Hozumi Masato Karayama Yuzo Suzuki Kazuki Furuhashi Noriyuki Enomoto Tomoyuki Fujisawa Naoki Inui Takafumi Suda Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis Therapeutic Advances in Respiratory Disease |
| title | Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis |
| title_full | Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis |
| title_fullStr | Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis |
| title_full_unstemmed | Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis |
| title_short | Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis |
| title_sort | prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis |
| url | https://doi.org/10.1177/1753466620953783 |
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