Incidence and changes in treatment of acute exacerbation of idiopathic pulmonary fibrosis in Japan: A claims-based retrospective study

Homma, Sakae; Suda, Takafumi; Hongo, Yoshie; Yoshida, Manami; Hiroi, Shinzo; Iwasaki, Kosuke; Takeshima, Tomomi; Kondoh, Yasuhiro

doi:10.1016/j.resinv.2022.07.004

Cited by 10 publications

(13 citation statements)

References 21 publications

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“…The incidence of IPF is 2.23 per 100,000, and its prevalence is 10.0 per 100,000 [22]. In addition, the annual incidence of acute exacerbations after IPF diagnosis was approximately 10 per 100 patient-years from the second year onwards [23]. Therefore, larger and long-term observational studies are warranted.…”

Section: Discussionmentioning

confidence: 99%

A possibility of pulmonary intravascular coagulopathy in acute exacerbation of interstitial lung diseases: a retrospective cohort study

Takeshita

Kurosawa

et al. 2023

Preprint

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Background Acute exacerbation (AE) of interstitial lung disease (ILD) is a life-threatening condition that can cause idiopathic pulmonary fibrosis (IPF) and non-IPF. One of the causes of the poor prognostic outcomes of AE-ILD is believed to be the coagulation cascade due to tissue damage. We investigated whether coagulopathy in patients with AE-ILD occurred locally in the lungs using laboratory data. Methods A total of 81 patients with chronic and acute ILD were enrolled in this study. A retrospective analysis was performed in two groups: a chronic ILD group comprising 63 outpatients and an acute ILD group comprising 18 inpatients diagnosed with AE-ILD. Results ROC analysis of SP-D, TAT, D-dimer, and PIC levels indicated that these four markers might be good diagnostic markers of AE-ILD. Spearman’s correlation coefficient analysis revealed a positive correlation between SP-D and TAT (r=0.711, p=0.004), D-dimer (r=0.626, p=0.011), and PIC (r=0.741, p=0.002). Multiple regression analysis performed for TAT values with age, male sex, baseline use of anticoagulant drugs, acute ILD, IL-6 value, and SP-D value showed that the model could explain 57.6% of TAT values (R2 = 0.609, adjusted R2 = 0.576). In addition, the baseline use of anticoagulant drugs (β=-6.8092, p<0.001), acute ILD (β=8.1475, p<0.001), and SP-D (β= 0.0137, p<0.001) were independent factors affecting TAT. Conclusion SP-D, TAT, D-dimer, and PIC may be useful markers for diagnosing AE-ILD. Based on these four serum markers, the present study suggests that coagulopathy caused by AE-ILD may occur locally in the lungs.

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Section: Discussionmentioning

confidence: 99%

A possibility of pulmonary intravascular coagulopathy in acute exacerbation of interstitial lung diseases: a retrospective cohort study

Takeshita

Kurosawa

et al. 2023

Preprint

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“…A total of ten studies [16][17][18][19][20][21][22][23][24][25] were included, of which 9 studies [16][17][18][20][21][22][23][24][25] were purely retrospective cohort study, and 1 study [19] included retrospective cohort study and prospective cohort study. The data mainly comes from four countries, namely South Korea, the United States, Italy, and Japan, including 11855 IPF patients, with a minimum sample size of 47 and a maximum sample size of 9961.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…The data mainly comes from four countries, namely South Korea, the United States, Italy, and Japan, including 11855 IPF patients, with a minimum sample size of 47 and a maximum sample size of 9961. Five studies [17,19,[22][23][24] reported on the number of males and females and median age of IPF, ve studies [18,[20][21][22][23] reported on the number of males and females and median age of AE IPF, and one study [25] only reported on the proportion of males in IPF and AE IPF, as well as the median age of AE IPF, without speci c values. The included studies were published from 2006 to 2022, with clear diagnostic criteria.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…The included studies were published from 2006 to 2022, with clear diagnostic criteria. The diagnostic criteria for three studies [19][20][21] were the 2000 American Thoracic Society (ATS)/European Respiratory Society criteria [26] , and the diagnostic criteria for three studies [16][17][18] were the 2002 American Thoracic Society (ATS)/European Respiratory Society (ERS) Compensation Classi cation [27] , The diagnostic criteria for three studies [22][23][24] were the 2011 o cial ATS/ERS/JRS/ALAT statement [28] , and the diagnostic criteria for one study [25] were the 2022 guidelines for the diagnosis and treatment of idiopathic interstitial pneumonia [29] . The basic characteristics of the included study are shown in Table 1.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Eight studies [16][17][18]20,[22][23][24][25] were included to report the incidence of acute exacerbation within one year. Using Metoprop analysis, the incidence of acute exacerbation within one year in IPF patients ranged from 4% to 14%, and the overall incidence of acute exacerbation was 9% (95% CI: 7-11%; I 2=73.25%, p=0.00), as shown in Figure 2.…”

Section: Incidence Of Acute Exacerbation Within One Year In Ipf Patientsmentioning

confidence: 99%

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The incidence of acute exacerbation of idiopathic pulmonary fibrosis: A systematic review and meta-analysis

wang,

Ji,

et al. 2024

Preprint

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Background: Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease with a high incidence of acute exacerbation and an increasing mortality rate. Currently, treatment methods and effects are limited. Therefore, we conducted a meta-analysis of the incidence of acute exacerbation in patients with IPF, hoping to provide reference for the prevention and management of IPF. Methods: We systematically searched the PubMed, Embase, Cochrane Library and Web of Science databases. From the creation of the database to the cohort study on April 3, 2023, we collected studies on the incidence of acute exacerbation of IPF patients, and used Stata software (version 16.0) for meta analysis. We used the Newcastle Ottawa Quality Assessment Scale (NOS) to assess the risk of bias for each study. We calculated the incidence of acute exacerbation in IPF patients and analyzed the risk and prognostic factors for acute exacerbation in IPF patients. Results: A total of ten cohort studys on the incidence of AE-IPF were included, including 11855 IPF patients. The results showed that the incidence of acute exacerbation within one year was 9%; the incidence of acute exacerbation within 2 years is 13%; the incidence of acute exacerbation within 3 years is 19%; the incidence of acute exacerbation within 4 years is 11%. In addition, one study reported an acute exacerbation rate of 1.9% within 30 days. The incidence of acute exacerbation within ten years reported in one study was 9.8%. One study included a retrospective cohort study and a prospective cohort study. In this study, the prospective cohort study showed that the incidence of acute exacerbation within 3 years was 18.6%, similar to the results of the retrospective cohort study meta-analysis. Conclusions: Our system evaluation and meta-analysis results show that the incidence of AE-IPF is relatively high. Therefore, sufficient attention should be paid to the research results, including the management and prevention of the disease, in order to reduce the risk of AE. Systematic review registration: PROSPERO, identifier CRD42022341323.

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Current and Future Treatment Landscape for Idiopathic Pulmonary Fibrosis

Bonella,

Spagnolo,

Ryerson

2023

Drugs

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Idiopathic pulmonary fibrosis (IPF) remains a disease with poor survival. The pathogenesis is complex and encompasses multiple molecular pathways. The first-generation antifibrotics pirfenidone and nintedanib, approved more than 10 years ago, have been shown to reduce the rate of progression, increase the length of life for patients with IPF, and work for other fibrotic lung diseases. In the last two decades, most clinical trials on IPF have failed to meet the primary endpoint and an urgent unmet need remains to identify agents or treatment strategies that can stop disease progression. The pharmacotherapeutic landscape for IPF is moving forward with a number of new drugs currently in clinical development, mostly in phase I and II trials, while only a few phase III trials are running. Since our understanding of IPF pathogenesis is still limited, we should keep focusing our efforts to deeper understand the mechanisms underlying this complex disease and their reflection on clinical phenotypes. This review discusses the key pathogenetic concepts for the development of new antifibrotic agents, presents the newest data on approved therapies, and summarizes new compounds currently in clinical development. Finally, future directions in antifibrotics development are discussed.

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Incidence and changes in treatment of acute exacerbation of idiopathic pulmonary fibrosis in Japan: A claims-based retrospective study

Cited by 10 publications

References 21 publications

A possibility of pulmonary intravascular coagulopathy in acute exacerbation of interstitial lung diseases: a retrospective cohort study

A possibility of pulmonary intravascular coagulopathy in acute exacerbation of interstitial lung diseases: a retrospective cohort study

The incidence of acute exacerbation of idiopathic pulmonary fibrosis: A systematic review and meta-analysis

Current and Future Treatment Landscape for Idiopathic Pulmonary Fibrosis

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