Effects of emphysema on physiological and prognostic characteristics of lung function in idiopathic pulmonary fibrosis

Yoon, Hee‐Young; Kim, Tae Hoon; Seo, Joon Beom; Lee, Sang Min; Lim, Soyeoun; Lee, Han Na; Kim, Namkug; Han, Minkyu; Kim, Dong Soon; Song, Jin Woo

doi:10.1111/resp.13387

Cited by 33 publications

(37 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As lung function progression might be affected by smoking status besides pulmonary fibrosis, 19 , 20 the mean change of FVC% pred and DLco% pred between smokers and non-smokers in patients who received pirfenidone treatment was compared. Although no statistical difference was found between different smoking status, non-smokers had the tendency to benefit more from pirfenidone treatment, reflected by the reduction in their lung function decline.…”

Section: Discussionmentioning

confidence: 99%

Real-life experiences in a single center: efficacy of pirfenidone in idiopathic pulmonary fibrosis and fibrotic idiopathic non-specific interstitial pneumonia patients

Feng

Zhao

et al. 2020

Ther Adv Respir Dis

View full text Add to dashboard Cite

Background: Pirfenidone is the first antifibrotic drug approved for the treatment of idiopathic pulmonary fibrosis (IPF) and it is used in the treatment of other interstitial pneumonias, such as unclassifiable interstitial lung disease (ILD) and connective tissue-related ILD. This study examined the efficacy of pirfenidone in patients with IPF and fibrotic idiopathic non-specific interstitial pneumonia (f-iNSIP). Methods: In a retrospective real-life study, 67 IPF and 24 f-iNSIP patients were enrolled and classified into a pirfenidone group and a non-antifibrotic group. The level of forced vital capacity (FVC) and diffusing capacity of lung for carbon monoxide (DLco) at baseline, 6, 12 and 24 months were recorded. The level of KL-6 in serum was detected by chemiluminescence enzyme immunoassay (CLEIA). The prognosis and safety outcomes were collected from patients. Results: In IPF patients, pirfenidone decreased the mean change of FVC and DLco, and decreased the proportion of patients with a ⩾10% decline in FVC or a ⩾15% decline in DLco compared with the non-antifibrotic group. There was no difference in the mean change of FVC and DLco between smokers and non-smokers who received pirfenidone treatment. There was an improvement in progression-free survival, defined as the time to the first occurrence of acute exacerbation or death related to pulmonary fibrosis. Moreover, the ratio of patients who experienced acute exacerbation and death related to pulmonary fibrosis was lower in the pirfenidone group. There was no change in lung function and prognosis between the pirfenidone and non-antifibrotic groups in f-iNSIP patients. The KL-6 level slightly decreased after 1 year of pirfenidone treatment but not significantly. Gastrointestinal and skin-related adverse events were most common, and four patients ceased treatment due to the side effects. Conclusions: Pirfenidone safely reduced disease progression by improving the lung function and progression-free survival in IPF patients, with acceptable side effects. The efficacy of pirfenidone on f-iNSIP was not significant, suggesting the need for further studies. The reviews of this paper are available via the supplemental material section.

show abstract

Section: Discussionmentioning

confidence: 99%

Real-life experiences in a single center: efficacy of pirfenidone in idiopathic pulmonary fibrosis and fibrotic idiopathic non-specific interstitial pneumonia patients

Feng

Zhao

et al. 2020

Ther Adv Respir Dis

View full text Add to dashboard Cite

show abstract

“…Yoon et al [15] reported that IPF was concomitant with emphysema in some lung fields in 42% of their patients, and this finding was based on high-resolution CT. In the present study, patients with CPFE had an LAA score ≥7, which implied that the lung field with emphysema was larger and the lung field with fibrosis was smaller in the CPFE group than the lung field with emphysema and the lung field with fibrosis in the IPF group.…”

Section: Discussionmentioning

confidence: 92%

Prognosis of patients with acute exacerbation of combined pulmonary fibrosis and emphysema: A retrospective single-center study

Ikuyama

Ushiki

Kosaka

et al. 2019

Preprint

View full text Add to dashboard Cite

BackgroundPrevious analyses of combined pulmonary fibrosis and emphysema (CPFE) cohorts have provided conflicting data on the survival of patients with CPFE. Therefore, the aim of this study was to investigate the clinical prognosis of acute exacerbation (AE) of CPFE.MethodsWe retrospectively reviewed the medical records of patients who had been treated at Shinshu University Hospital (Matsumoto, Japan) between 2003 and 2017. We identified 21 patients with AE of CPFE and 41 patients with AE of idiopathic pulmonary fibrosis (IPF) and estimated their prognoses using the Kaplan–Meier method.ResultsTreatment content and respiratory management were not significantly different between the two groups before and after exacerbation. At the time of AE, the median serum Krebs von den Lungen-6 level was significantly lower in the CPFE group (Krebs von den Lungen-6: 966 U/µL; white blood cell count: 8810 /µL) than that in the IPF group (Krebs von den Lungen-6: 2130 U/µL, p < 0.001; white blood cells: 10809/µL, p = 0.0096). The baseline Gender-Age-Physiology score was not significantly different between the two groups (CPFE, 4.5 points; IPF, 4.7 points; p = 0.58). Kaplan–Meier curves revealed that the survival time after AE for patients with CPFE was longer than that for patients with IPF (p < 0.001, log-rank test).ConclusionsSurvival prognoses after AE were significantly better for patients with CPFE than that for patients with IPF. Our findings may improve the medical treatment and respiratory management of patients with AE-CPFE.

show abstract

“…Yoon et al [15] reported that IPF developed concomitantly with emphysema in some lung fields in 42% of their patients, and this finding was based on high-resolution CT. In the present study, patients with CPFE had an LAA score ≥7, which implied that the lung field with emphysema was larger and that with fibrosis was smaller in the CPFE group, than the lung field with emphysema and the lung field with fibrosis in the IPF group.…”

Section: Discussionmentioning

confidence: 94%

Prognosis of patients with acute exacerbation of combined pulmonary fibrosis and emphysema: A retrospective single-center study

Ikuyama¹,

Ushiki²,

Kosaka³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Previous analyses of combined pulmonary fibrosis and emphysema (CPFE) cohorts have provided conflicting data on the survival of patients with CPFE. Therefore, the aim of this study was to investigate the clinical prognosis of acute exacerbations (AE) of CPFE.Methods: We retrospectively reviewed the medical records of patients who had been treated at the Shinshu University Hospital (Matsumoto, Japan) between 2003 and 2017. We identified 21 patients with AE of CPFE and 41 patients with AE of idiopathic pulmonary fibrosis (IPF) and estimated their prognoses using the Kaplan–Meier method.Results: Treatment content and respiratory management were not significantly different between the two groups before and after exacerbation. At the time of AE, the median serum Krebs von den Lungen-6 level was significantly lower in the CPFE group (Krebs von den Lungen-6: 966 U/µL; white blood cell count: 8810 /µL) than that in the IPF group (Krebs von den Lungen-6: 2130 U/µL, p < 0.001; white blood cells: 10809/µL, p = 0.0096). The baseline Gender-Age-Physiology scores were not significantly different between the two groups (CPFE, 4.5 points; IPF, 4.7 points; p = 0.58). Kaplan–Meier curves revealed that the survival time after AE for patients with CPFE was longer than that for patients with IPF (p < 0.001, log-rank test).Conclusions: Survival prognoses after AE were significantly better for patients with CPFE than that for those with IPF. Our findings may improve the medical treatment and respiratory management of patients with AE-CPFE.

show abstract

Effects of emphysema on physiological and prognostic characteristics of lung function in idiopathic pulmonary fibrosis

Abstract: In IPF, emphysema to an extent of ≥10% affects both the annual decline rate and the prognostic significance of FVC. This extent could be used to define CPFE.

Cited by 33 publications

References 34 publications

Real-life experiences in a single center: efficacy of pirfenidone in idiopathic pulmonary fibrosis and fibrotic idiopathic non-specific interstitial pneumonia patients

Real-life experiences in a single center: efficacy of pirfenidone in idiopathic pulmonary fibrosis and fibrotic idiopathic non-specific interstitial pneumonia patients

Prognosis of patients with acute exacerbation of combined pulmonary fibrosis and emphysema: A retrospective single-center study

Prognosis of patients with acute exacerbation of combined pulmonary fibrosis and emphysema: A retrospective single-center study

Contact Info

Product

Resources

About