The Impact of Switching to a Second Antifibrotic in Patients With Idiopathic Pulmonary Fibrosis: A Retrospective Multicentre Study From the EMPIRE Registry

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dc.authoridGregor, Jakub/0000-0003-2431-7873
dc.contributor.authorGregor, Jakub
dc.contributor.authorAdir, Yochai
dc.contributor.authorSterclova, Martina
dc.contributor.authorMogulkoc, Nesrin
dc.contributor.authorKramer, Mordechai R.
dc.contributor.authorDoubkova, Martina
dc.contributor.authorPlackova, Martina
dc.date.accessioned2024-08-31T07:50:14Z
dc.date.available2024-08-31T07:50:14Z
dc.date.issued2024
dc.departmentEge Üniversitesien_US
dc.description.abstractIntroduction: 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.en_US
dc.description.sponsorshipBoehringer Ingelheim; F. Hoffman-La Rocheen_US
dc.description.sponsorshipThe EMPIRE registry was supported by Boehringer Ingelheim and F. Hoffman-La Roche. The funders had no role in the design, analysis, or interpretation of the results in this study. The funders were given the opportunity to review the manuscript for medical and scientific accuracy, as well as intellectual property considerations.en_US
dc.identifier.doi10.1016/j.arbres.2023.12.002
dc.identifier.endpage87en_US
dc.identifier.issn0300-2896
dc.identifier.issn1579-2129
dc.identifier.issue2en_US
dc.identifier.pmid38160169en_US
dc.identifier.scopus2-s2.0-85181946229en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage80en_US
dc.identifier.urihttps://doi.org/10.1016/j.arbres.2023.12.002
dc.identifier.urihttps://hdl.handle.net/11454/105162
dc.identifier.volume60en_US
dc.identifier.wosWOS:001170483700001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Espana Sluen_US
dc.relation.ispartofArchivos De Bronconeumologiaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240831_Uen_US
dc.subjectRegistriesen_US
dc.subjectAntifibrotic Agentsen_US
dc.subjectSurvivalen_US
dc.subjectTreatment Switchen_US
dc.titleThe Impact of Switching to a Second Antifibrotic in Patients With Idiopathic Pulmonary Fibrosis: A Retrospective Multicentre Study From the EMPIRE Registryen_US
dc.typeArticleen_US

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