2024
The Impact of Switching to a Second Antifibrotic in Patients With Idiopathic Pulmonary Fibrosis: A Retrospective Multicentre Study From the EMPIRE Registry
GREGOR, Jakub, Yochai ADIR, Martina STERCLOVA, Nesrin MOGULKOC, Mordechai R KRAMER et. al.Základní údaje
Originální název
The Impact of Switching to a Second Antifibrotic in Patients With Idiopathic Pulmonary Fibrosis: A Retrospective Multicentre Study From the EMPIRE Registry
Autoři
GREGOR, Jakub (203 Česká republika, domácí), Yochai ADIR, Martina STERCLOVA (203 Česká republika), Nesrin MOGULKOC, Mordechai R KRAMER, Martina DOUBKOVÁ (203 Česká republika, domácí), Martina PLACKOVA (203 Česká republika), Veronika MULLER, Michael STUDNICKA (203 Česká republika), Monika ZURKOVA (203 Česká republika), Ladislav LACINA (203 Česká republika), Katarzyna LEWANDOWSKA, Vladimir BARTOS (203 Česká republika), Petra OVESNÁ (203 Česká republika, domácí), Ondřej MÁJEK (203 Česká republika, domácí) a Martina KOZIAR VASAKOVA (203 Česká republika)
Vydání
ARCHIVOS DE BRONCONEUMOLOGIA, BARCELONA, ELSEVIER ESPANA SLU, 2024, 0300-2896
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30203 Respiratory systems
Stát vydavatele
Španělsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 8.000 v roce 2022
Organizační jednotka
Lékařská fakulta
UT WoS
001170483700001
Klíčová slova anglicky
Registries; Antifibrotic agents; Survival; Treatment switch
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 3. 5. 2024 13:39, Mgr. Tereza Miškechová
Anotace
V originále
Introduction: Most patients with idiopathic pulmonary fibrosis (IPF) treated with antifibrotics (AF) have progressive disease despite treatment. A switch of AF may improve survival, but evidence from randomised controlled trials is missing. We aimed to evaluate the efficacy of an AF switch on survival and FVC decline in patients from the European MultiPartner IPF registry (EMPIRE). Methods: The study included 612 patients who discontinued the first antifibrotic therapy. Patients were grouped and analysed from two perspectives: (1) whether they had received a second antifibrotic treatment after the discontinuation of the first therapy, and (2) a reason for discontinuation of the first AF - "lack of efficacy" (LE) and "intolerance" (INT). Results: While 263 (43%) of 612 patients received no second AF ("non-switched"), 349 (57%) patients switched. Overall survival was higher in patients who received a second AF (median 50 vs. 29 months; adjusted HR 0.64, P=0.023). Similarly, the annual FVC decline was significantly reduced in switched patients: -98ml/y in switched and -172ml/y in non-switched patients (P=0.023), respectively. The switched patients had similar risk for mortality in both LE and INT groups (adjusted HR 0.95, P=0.85). The high impact of switching on survival was demonstrated in LE patients (adjusted HR 0.27, P<0.001). Conclusion: The patients without a second AF had significantly shorter overall survival. Our analysis suggests the importance of switching patients with an ineffective first AF therapy to a second AF therapy.