Antacid therapy and disease progression in patients with idiopathic pulmonary fibrosis who received pirfenidone
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background: Gastroesophageal reflux disease is a potential risk factor for idiopathic pulmonary fibrosis (IPF) progression; however, the impact of antacid therapy (AAT) is under debate. Objective: To evaluate the effect of AAT on IPF progression in pirfenidone-treated patients. Methods: This post hoc analysis included patients with IPF who received pirfenidone in 3 trials (CAPACITY [PIPF-004/PIPF-006] and ASCEND [PIPF-016]). Pulmonary function, exercise tolerance, survival, hospitalizations, and adverse events (AEs) over 52 weeks were analyzed by baseline AAT use. Disease progression was defined as a decrease in forced vital capacity (FVC) of ≥10%, a decrease in 6-min walking distance of ≥50 m, or death over 1 year. Results: Of 623 patients, 44% received AAT. No significant differences were found at 52 weeks (AAT versus non-AAT, respectively) in disease progression (24.9 vs. 30.6%; p = 0.12), all-cause mortality rate (2.9 vs. 4.0%; p = 0.47), IPF-related mortality rate (1.1 vs. 2.0%; p = 0.37), all-cause hospitalization rate (16.1 vs. 18.3%; p = 0.48), or mean change in percent FVC (-2.7 vs. -3.1%; p = 0.44). A relative, but not absolute, FVC decline of ≥10% favored AAT (15 vs. 22%; p = 0.03). Severe gastrointestinal AEs (3.7 vs. 0.9%; p = 0.015) and severe pulmonary infections (3.7 vs. 1.1%; p = 0.035) were more frequent with AAT. Conclusions: AAT and pirfenidone had outcomes comparable to those of pirfenidone alone in patients with IPF, underscoring the need for prospective trials to elucidate the role of AAT with or without antifibrotic drugs as a treatment for IPF.
Date Issued
2017-04-12
Date Acceptance
2017-03-06
Citation
Respiration, 2017, 93 (6), pp.415-423
ISSN
1423-0356
Publisher
Karger Publishers
Start Page
415
End Page
423
Journal / Book Title
Respiration
Volume
93
Issue
6
Copyright Statement
© 2017 The Author(s) Published by S. Karger AG, Basel. Th
is article is licensed under the Creative Commons Attribution-
NonCommercial-NoDerivatives 4.0 International License (CC BY-
NC-ND) (http://www.karger.com/Services/OpenAccessLicense).
Usage and distribution for commercial purposes as well as any dis-
tribution of modifi
ed material requires written permission.
is article is licensed under the Creative Commons Attribution-
NonCommercial-NoDerivatives 4.0 International License (CC BY-
NC-ND) (http://www.karger.com/Services/OpenAccessLicense).
Usage and distribution for commercial purposes as well as any dis-
tribution of modifi
ed material requires written permission.
Sponsor
Raynaud's and Scleroderma Association
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000402748200007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
BR11
Subjects
Science & Technology
Life Sciences & Biomedicine
Respiratory System
Antacid therapy
Gastroesophageal reflux disease
Idiopathic pulmonary fibrosis
Pirfenidone
Progression-free survival
GASTROESOPHAGEAL-REFLUX DISEASE
TRIALS
RECLASSIFICATION
PREVALENCE
GUIDELINES
MANAGEMENT
INHIBITORS
PNEUMONIA
DIAGNOSIS
OUTCOMES
Publication Status
Published