Comorbidity burden and survival in patients with idiopathic pulmonary fibrosis: the EMPIRE registry study

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dc.authoridLewandowska, Katarzyna/0000-0002-4648-2864
dc.authoridKontic Jovanovic, Milica/0000-0003-1285-3812
dc.authorscopusid7102247807
dc.authorscopusid57203066779
dc.authorscopusid6603063177
dc.authorscopusid57197907129
dc.authorscopusid7102893051
dc.authorscopusid6701659308
dc.authorscopusid55611305900
dc.contributor.authorJovanovic, Dragana M.
dc.contributor.authorSterclova, Martina
dc.contributor.authorMogulkoc, Nesrin
dc.contributor.authorLewandowska, Katarzyna
dc.contributor.authorMuller, Veronika
dc.contributor.authorHajkova, Marta
dc.contributor.authorStudnicka, Michael
dc.date.accessioned2023-01-12T20:04:42Z
dc.date.available2023-01-12T20:04:42Z
dc.date.issued2022
dc.departmentN/A/Departmenten_US
dc.description.abstractBackground Patients with idiopathic pulmonary fibrosis (IPF) frequently have multiple comorbidities, which may influence survival but go under-recognised in clinical practice. We therefore report comorbidity, antifibrotic treatment use and survival of patients with IPF observed in the multi-national EMPIRE registry. Methods For this prospective IPF cohort, demographics, comorbidities, survival and causes of death were analysed. Comorbidities were noted by the treating physician based on the patient's past medical history or as reported during follow-up. Comorbidities were defined as prevalent when noted at enrolment, or as incident when recorded during follow-up. Survival was analysed by Kaplan-Meier estimates, log-rank test, and Cox proportional hazards models. Hazard ratios (HR) were adjusted for gender, age, smoking status and FVC at enrolment. Results A population of 3,580 patients with IPF from 11 Central and Eastern European countries was followed every 6 months for up to 6 years. At enrolment, 91.3% of patients reported at least one comorbidity, whereas more than one-third (37.8%) reported four or more comorbidities. Five-year survival was 53.7% in patients with no prevalent comorbidities, whereas it was 48.4%, 47.0%, 43.8% and 41.1% in patients with 1, 2, 3 and >= 4 comorbidities, respectively. The presence of multiple comorbidities at enrolment was associated with significantly worse survival (log-rank test P = 0.007). Adjusted HRs indicate that risk of death was increased by 44% in patients with IPF reporting >= 4 comorbidities at baseline compared with no comorbidity (P = 0.021). The relationship between number of comorbidities and decreased survival was also seen in patients receiving antifibrotic treatment (63% of all patients; log-rank test P < 0.001). Comorbidity as cause of death was identified in at least 26.1% of deaths. Conclusions The majority of patients with IPF demonstrate comorbidities, and many have comorbidity-related deaths. Increasing numbers of comorbidities are associated with worse survival; and this pattern is also present in patients receiving antifibrotic therapy.en_US
dc.description.sponsorshipBoehringer Ingelheim; Rocheen_US
dc.description.sponsorshipThe EMPIRE registry is supported in part by Boehringer Ingelheim and Roche. The authors did not receive payment for the development of the manuscript.en_US
dc.identifier.doi10.1186/s12931-022-02033-6
dc.identifier.issn1465-993X
dc.identifier.issue1en_US
dc.identifier.pmid35624513en_US
dc.identifier.scopus2-s2.0-85131108254en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1186/s12931-022-02033-6
dc.identifier.urihttps://hdl.handle.net/11454/77816
dc.identifier.volume23en_US
dc.identifier.wosWOS:000804188600001en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBmcen_US
dc.relation.ispartofRespiratory Researchen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectEMPIREen_US
dc.subjectMortalityen_US
dc.subjectIdiopathic pulmonary fibrosisen_US
dc.subjectRegistryen_US
dc.subjectPrevalenceen_US
dc.subjectHypertensionen_US
dc.subjectPirfenidoneen_US
dc.subjectManagementen_US
dc.subjectImpacten_US
dc.titleComorbidity burden and survival in patients with idiopathic pulmonary fibrosis: the EMPIRE registry studyen_US
dc.typeArticleen_US

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