Monocyte count and decline in forced vital capacity (FVC) in patients with IPF

Τzouvelekis, Αrgyris; Maher, Toby M.; Goh, Nicole; Kreuter, Michael; Cottin, Vincent; Schinzel, Birgit; Orsatti, Leticia; Corte, Tamera J.

doi:10.1183/13993003.congress-2020.721

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“…However, monocyte count and RDW were not associated with 1-year FVC%pred and DLCO%pred decline. Similarly to our findings, recent evidence using pooled data from the TOMORROW and INPULSIS trials, showed that the adjusted rate of FVC decline was similar between patients with high and low monocyte count receiving nintedanib [ 32 ]. Nonetheless, there is still a major knowledge gap for the longitudinal prognostic and theragnostic role of these biomarkers.…”

Section: Discussionsupporting

confidence: 90%

“…Nonetheless, there is still a major knowledge gap for the longitudinal prognostic and theragnostic role of these biomarkers. The prognostic role of monocyte count in FVC decline requires further investigation, as its prognostic accuracy might be associated with the baseline status, the selected treatment or the population investigated [ 29 , 32 ]. Further large studies are needed to address this issue, focusing on subgroup of patients that have been subjected to different treatment modalities.…”

Section: Discussionmentioning

confidence: 99%

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Increased monocyte count and red cell distribution width as prognostic biomarkers in patients with Idiopathic Pulmonary Fibrosis

et al. 2021

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Background Idiopathic Pulmonary Fibrosis (IPF) represents a chronic lung disease with unpredictable course. Methods We aimed to investigate prognostic performance of complete blood count parameters in IPF. Treatment-naïve patients with IPF were retrospectively enrolled from two independent cohorts (derivation and validation) and split into subgroups (high and low) based on median baseline monocyte count and red cell distribution width (RDW). Results Overall, 489 patients (derivation cohort: 300, validation cohort: 189) were analyzed. In the derivation cohort, patients with monocyte count ≥ 0.60 K/μL had significantly lower median FVC%pred [75.0, (95% CI 71.3–76.7) vs. 80.9, (95% CI 77.5–83.1), (P = 0.01)] and DLCO%pred [47.5, (95% CI 44.3–52.3) vs. 53.0, (95% CI 48.0–56.7), (P = 0.02)] than patients with monocyte count < 0.60 K/μL. Patients with RDW ≥ 14.1% had significantly lower median FVC%pred [75.5, (95% CI 71.2–79.2) vs. 78.3, (95% CI 76.0–81.0), (P = 0.04)] and DLCO%pred [45.4, (95% CI 43.3–50.5) vs. 53.0, (95% CI 50.8–56.8), (P = 0.008)] than patients with RDW < 14.1%. Cut-off thresholds from the derivation cohort were applied to the validation cohort with similar discriminatory value, as indicated by significant differences in median DLCO%pred between patients with high vs. low monocyte count [37.8, (95% CI 35.5–41.1) vs. 45.5, (95% CI 41.9–49.4), (P < 0.001)] and RDW [37.9, (95% CI 33.4–40.7) vs. 44.4, (95% CI 41.5–48.9), (P < 0.001)]. Patients with high monocyte count and RDW of the validation cohort exhibited a trend towards lower median FVC%pred (P = 0.09) and significantly lower median FVC%pred (P = 0.001), respectively. Kaplan–Meier analysis in the derivation cohort demonstrated higher all-cause mortality in patients with high (≥ 0.60 K/μL) vs. low monocyte count (< 0.60 K/μL) [HR 2.05, (95% CI 1.19–3.53), (P = 0.01)]. Conclusions Increased monocyte count and RDW may represent negative prognostic biomarkers in patients with IPF.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%