Researchers discovered that patients with idiopathic pulmonary fibrosis (IPF) tend to have multiple comorbidities, which is associated with poorer survival, even in patients receiving antifibrotic therapy, as published in Respiratory Research.

Patients with IPF often struggle with a high disease burden and experience pulmonary and extrapulmonary comorbidities. These commodities can be caused by risk factors such as age and smoking. Among the more common comorbidities in patients with IPF are diabetes mellitus, coronary heart disease, chronic obstructive pulmonary disease, and obstructive sleep apnea. 

“We aimed to estimate the prevalence of comorbidities . . . as well as the incidence of comorbidities during follow-up, and to analyse the impact on survival,” the authors of the study wrote.


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The research team used data from an existing clinical study known as EMPIRE and recruited patients who had a diagnosis of IPF. For selected participants, the data collected in relation to their illness included diagnosis, comorbidities, lung function, antifibrotic treatment, survival, and cause of death. The patients were treated with either pirfenidone or nintedanib.

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The results demonstrated that patients who received antifibrotic treatment demonstrated differences in survival based on the number of comorbidities at enrollment.

“The median number of comorbidities at enrolment was three, and a greater number of comorbidities was associated with significantly worse survival, resulting in a 41% increased risk of death for those with four or more comorbidities at baseline,” the authors said.

In addition, the study found that certain comorbidities were significantly associated with poorer survival. In particular, cardiovascular disease is a significant predictor of mortality among patients with IPF.

“Comorbidities in IPF are common but may often be under-recognised in clinical practice,” the authors concluded. “Raising awareness of the impact that comorbidities can have on these patients would help to improve recognition and management in clinical practice.”

Reference

Jovanovic DM, Šterclová M, Mogulkoc N, et al. Comorbidity burden and survival in patients with idiopathic pulmonary fibrosis: the EMPIRE registry studyRespir Res. 2022;23(1):135. doi:10.1186/s12931-022-02033-6