Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland
Background: Pirfenidone and nintedanib are considered as the standard of care in idiopathic pulmonary fibrosis (IPF), but there is no consensus as to which of these two agents should be regarded as first-line treatment. Objective: To provide real-world data on therapeutic decisions of pulmonary spec...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-08-01
|
| Series: | Therapeutic Advances in Chronic Disease |
| Online Access: | https://doi.org/10.1177/20406223221117982 |
| _version_ | 1817998713496272896 |
|---|---|
| author | Katarzyna Górska Marta Maskey-Warzęchowska Małgorzata Barnaś Adam Białas Adam Barczyk Hanna Jagielska-Len Ewa Jassem Aleksander Kania Katarzyna Lewandowska Sebastian Majewski Magdalena M. Martusewicz-Boros Wojciech J. Piotrowski Alicja Siemińska Krzysztof Sładek Małgorzata Sobiecka Marzena Trzaska-Sobczak Witold Tomkowski Beata Żołnowska Rafał Krenke |
| author_facet | Katarzyna Górska Marta Maskey-Warzęchowska Małgorzata Barnaś Adam Białas Adam Barczyk Hanna Jagielska-Len Ewa Jassem Aleksander Kania Katarzyna Lewandowska Sebastian Majewski Magdalena M. Martusewicz-Boros Wojciech J. Piotrowski Alicja Siemińska Krzysztof Sładek Małgorzata Sobiecka Marzena Trzaska-Sobczak Witold Tomkowski Beata Żołnowska Rafał Krenke |
| author_sort | Katarzyna Górska |
| collection | DOAJ |
| description | Background: Pirfenidone and nintedanib are considered as the standard of care in idiopathic pulmonary fibrosis (IPF), but there is no consensus as to which of these two agents should be regarded as first-line treatment. Objective: To provide real-world data on therapeutic decisions of pulmonary specialists, particularly the choice of the antifibrotic drug in patients with IPF. Methods: This was a multicenter, prospective survey collecting clinical data of patients with IPF considered as candidates for antifibrotic treatment between September 2019 and December 2020. Clinical characteristics and information on the therapeutic approach were retrieved. Statistical evaluation included multiple logistic regression analysis with stepwise model selection. Results: Data on 188 patients [74.5% male, median age 73 (interquartile range, 68–78) years] considered for antifibrotic therapy were collected. Treatment was initiated in 138 patients, while 50 patients did not receive an antifibrotic, mainly due to the lack of consent for treatment and IPF severity. Seventy-two patients received pirfenidone and 66 received nintedanib. Dosing protocol ( p < 0.01) and patient preference ( p = 0.049) were more frequently associated with the choice of nintedanib, while comorbidity profile ( p = 0.0003) and concomitant medication use ( p = 0.03) were more frequently associated with the choice of pirfenidone. Age ( p = 0.002), lung transfer factor for carbon monoxide (TL CO ) ( p = 0.001), and gastrointestinal bleeding ( p = 0.03) were significantly associated with the qualification for the antifibrotic treatment. Conclusion: This real-world prospective study showed that dose protocol and patient preference were more frequently associated with the choice of nintedanib, while the comorbidity profile and concomitant medication use were more frequently associated with the choice of pirfenidone. Age, TL CO , and history of gastrointestinal bleeding were significant factors influencing the decision to initiate antifibrotic therapy. |
| first_indexed | 2024-04-14T02:57:33Z |
| format | Article |
| id | doaj.art-f292078d43f34b2ea0136d89cf7f4dc6 |
| institution | Directory Open Access Journal |
| issn | 2040-6231 |
| language | English |
| last_indexed | 2024-04-14T02:57:33Z |
| publishDate | 2022-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Chronic Disease |
| spelling | doaj.art-f292078d43f34b2ea0136d89cf7f4dc62022-12-22T02:16:03ZengSAGE PublishingTherapeutic Advances in Chronic Disease2040-62312022-08-011310.1177/20406223221117982Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from PolandKatarzyna GórskaMarta Maskey-WarzęchowskaMałgorzata BarnaśAdam BiałasAdam BarczykHanna Jagielska-LenEwa JassemAleksander KaniaKatarzyna LewandowskaSebastian MajewskiMagdalena M. Martusewicz-BorosWojciech J. PiotrowskiAlicja SiemińskaKrzysztof SładekMałgorzata SobieckaMarzena Trzaska-SobczakWitold TomkowskiBeata ŻołnowskaRafał KrenkeBackground: Pirfenidone and nintedanib are considered as the standard of care in idiopathic pulmonary fibrosis (IPF), but there is no consensus as to which of these two agents should be regarded as first-line treatment. Objective: To provide real-world data on therapeutic decisions of pulmonary specialists, particularly the choice of the antifibrotic drug in patients with IPF. Methods: This was a multicenter, prospective survey collecting clinical data of patients with IPF considered as candidates for antifibrotic treatment between September 2019 and December 2020. Clinical characteristics and information on the therapeutic approach were retrieved. Statistical evaluation included multiple logistic regression analysis with stepwise model selection. Results: Data on 188 patients [74.5% male, median age 73 (interquartile range, 68–78) years] considered for antifibrotic therapy were collected. Treatment was initiated in 138 patients, while 50 patients did not receive an antifibrotic, mainly due to the lack of consent for treatment and IPF severity. Seventy-two patients received pirfenidone and 66 received nintedanib. Dosing protocol ( p < 0.01) and patient preference ( p = 0.049) were more frequently associated with the choice of nintedanib, while comorbidity profile ( p = 0.0003) and concomitant medication use ( p = 0.03) were more frequently associated with the choice of pirfenidone. Age ( p = 0.002), lung transfer factor for carbon monoxide (TL CO ) ( p = 0.001), and gastrointestinal bleeding ( p = 0.03) were significantly associated with the qualification for the antifibrotic treatment. Conclusion: This real-world prospective study showed that dose protocol and patient preference were more frequently associated with the choice of nintedanib, while the comorbidity profile and concomitant medication use were more frequently associated with the choice of pirfenidone. Age, TL CO , and history of gastrointestinal bleeding were significant factors influencing the decision to initiate antifibrotic therapy.https://doi.org/10.1177/20406223221117982 |
| spellingShingle | Katarzyna Górska Marta Maskey-Warzęchowska Małgorzata Barnaś Adam Białas Adam Barczyk Hanna Jagielska-Len Ewa Jassem Aleksander Kania Katarzyna Lewandowska Sebastian Majewski Magdalena M. Martusewicz-Boros Wojciech J. Piotrowski Alicja Siemińska Krzysztof Sładek Małgorzata Sobiecka Marzena Trzaska-Sobczak Witold Tomkowski Beata Żołnowska Rafał Krenke Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland Therapeutic Advances in Chronic Disease |
| title | Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland |
| title_full | Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland |
| title_fullStr | Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland |
| title_full_unstemmed | Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland |
| title_short | Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland |
| title_sort | therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis a multicenter prospective survey from poland |
| url | https://doi.org/10.1177/20406223221117982 |
| work_keys_str_mv | AT katarzynagorska therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT martamaskeywarzechowska therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT małgorzatabarnas therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT adambiałas therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT adambarczyk therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT hannajagielskalen therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT ewajassem therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT aleksanderkania therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT katarzynalewandowska therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT sebastianmajewski therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT magdalenammartusewiczboros therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT wojciechjpiotrowski therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT alicjasieminska therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT krzysztofsładek therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT małgorzatasobiecka therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT marzenatrzaskasobczak therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT witoldtomkowski therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT beatazołnowska therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland AT rafałkrenke therapeuticdecisionsinacohortofpatientswithidiopathicpulmonaryfibrosisamulticenterprospectivesurveyfrompoland |