J 2019

Effect of pirfenidone on lung function decline and survival: 5-yr experience from a real-life IPF cohort from the Czech EMPIRE registry

ZURKOVA, Monika, Eva KRIEGOVA, Vitezslav KOLEK, Vladimira LOSTAKOVA, Martina STERCLOVA et. al.

Basic information

Original name

Effect of pirfenidone on lung function decline and survival: 5-yr experience from a real-life IPF cohort from the Czech EMPIRE registry

Authors

ZURKOVA, Monika (203 Czech Republic), Eva KRIEGOVA (203 Czech Republic, guarantor), Vitezslav KOLEK (203 Czech Republic), Vladimira LOSTAKOVA (203 Czech Republic), Martina STERCLOVA (203 Czech Republic), Vladimir BARTOS (203 Czech Republic), Martina DOUBKOVÁ (203 Czech Republic, belonging to the institution), Ilona BINKOVÁ (203 Czech Republic), Michal SVOBODA (203 Czech Republic, belonging to the institution), Jana STRENKOVÁ (203 Czech Republic, belonging to the institution), Marketa JANOTOVA (203 Czech Republic), Martina PLACKOVA (203 Czech Republic), Ladislav LACINA (203 Czech Republic), Vladimir RIHAK (203 Czech Republic), Frantisek PETRIK (203 Czech Republic), Pavlina LISA (203 Czech Republic), Radka BITTENGLOVA (203 Czech Republic), Richard TYL (203 Czech Republic), Gustav ONDREJKA (203 Czech Republic), Hana SULDOVA (203 Czech Republic), Jaroslav LNENICKA (203 Czech Republic), Jana PSIKALOVA (203 Czech Republic), Tomas SNIZEK (203 Czech Republic), Jiri HOMOLKA (203 Czech Republic), Renata KRALOVA (203 Czech Republic), Jan KERVITZER (203 Czech Republic) and Martina VASAKOVA (203 Czech Republic)

Edition

RESPIRATORY RESEARCH, LONDON, BMC, 2019, 1465-993X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.924

RIV identification code

RIV/00216224:14110/19:00109452

Organization unit

Faculty of Medicine

UT WoS

000458078000002

Keywords in English

Idiopathic pulmonary fibrosis; Pirfenidone; Mortality prediction; Disease progression

Tags

International impact, Reviewed
Změněno: 2/6/2020 13:56, Mgr. Tereza Miškechová

Abstract

V originále

Pirfenidone, an antifibrotic drug, slows-down the disease progression in idiopathic pulmonary fibrosis (IPF) over 12 months, however limited data on the decline of lung function and overall survival (OS) in real-world cohorts on longer follow-up exists. Of the enrolled Czech IPF patients (n = 841) from an EMPIRE registry, 383 (45.5%) received pirfenidone, 218 (25.9%) no-antifibrotic treatment and 240 (28.5%) were excluded (missing data, nintedanib treatment). The 2- and 5-yrs OS and forced vital capacity (FVC) and diffusing lung capacity for carbon monoxide (DLCO) were investigated at treatment initiation and 6, 12, 18 and 24 months' follow-up. During a 2-yr follow-up, less than a quarter of the patients progressed on pirfenidone as assessed by the decline of ae10% FVC (17.0%) and ae 15% DLCO (14.3%). On pirfenidone, the DLCO (ae10%) declines at 6, 12, 18 and 24 months' and DLCO (ae15%) declines at 6, 18 and 24 months' follow-up were associated with increased mortality. The DLCO decline showed higher predictive value for mortality than FVC decline. In patients with no-antifibrotics, FVC and DLCO declines were not predictive for mortality. Pirfenidone increased 5-yrs OS over no-antifibrotic treatment (55.9% vs 31.5% alive, P = 0.002). Our study observed the 2-yrs sustained effect of pirfenidone on the decline of lung function and survival in the real-world patient's IPF cohort. DLCO decline of ae10% shows a potential as a mortality predictor in IPF patients on pirfenidone, and should be routinely evaluated during follow-up examinations.