Advancing the Science

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September 21, 2021

Antifibrotics may extend lives for patients with IPF

By Elizabeth Zimmermann

Mayo Clinic researchers recently learned that patients who are taking antifibrotic drugs for idiopathic pulmonary fibrosis (IPF) have a better chance of survival after a respiratory-related hospitalization compared to patients not receiving these medications. The study, which was supported by Three Lakes Foundation, was published recently in BMC Pulmonary Medicine.

Read Three Lakes news release.

In addition to his physician role, Dr. Limper holds a joint appointment in Biochemistry and Molecular Biology, is the Robert D. and Patricia E. Kern Associate Dean of Practice Transformation, and the Walter and Leonore Annenberg Professor of Pulmonary Medicine.

“To our knowledge, this is the first use of real-world data to evaluate the impact of antifibrotics on hospitalization outcomes,” says Andrew Limper, M.D., a pulmonary and critical care physician at Mayo Clinic, and the study's senior author. “Our findings are unique in that we tracked patients — with and without antifibrotics — after a hospitalization event, demonstrating the role antifibrotics have in improving survival for up to two years of therapy as well as in decreasing the number of hospitalizations.”

Dr. Limper and his research team used the OptumLabs Data Warehouse to create a matched cohort of patients with idiopathic pulmonary fibrosis treated and untreated with an antifibrotic who underwent respiratory-related hospitalization between Jan. 1, 2015, and Dec. 31, 2018. They examined mortality rates at 30 days and at the end of a follow-up period of up to two years. The investigators also looked at outcomes for patients who received treatment in the ICU, and for those who received invasive or non-invasive mechanical ventilation during their initial hospitalization. OptumLabs Data Warehouse is a longitudinal, real-world data asset with de-identified administrative claims and electronic health record data.

The full patient data set included 402 treated and 2,511 untreated patients with idiopathic pulmonary fibrosis. This provided the researchers with 402 propensity-matched pairs of treated and untreated patients. There were 274 pairs of patients in the group of patients who experienced an ICU hospitalization, 94 sets of whom had required mechanical ventilation.

The team observed that existing use of antifibrotic medications did not appear to affect whether or not a patient's initial hospitalization included a stay in the ICU or mechanical ventilation. Neither was there an effect on 30-day mortality. However, as patients were followed in their care, for up to two years, the team found that mortality was reduced in the treated cohort compared to the untreated cohort when followed up to two years (20.1% versus 47.8%).

In addition to the Three Lakes Foundation, this research was supported by the  Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care DeliveryOptumLabs is a collaborative center for research and innovation, co-founded by Optum Inc. and Mayo Clinic, which focuses on improving patient care and patient value. The Mayo Clinic Kern Center for the Science of Health Care Delivery, which leads Mayo Clinic’s relationship with OptumLabs, has published a number of studies identifying areas for potential improvements in health care delivery and patient outcomes using the OptumLabs Data Warehouse.

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Tags: Andrew Limper, Center for the Science of Health Care Delivery, Findings, idiopathic pulmonary fibrosis, News, OptumLabs

Very informative, thank you.

With the current and forecasted burden of pulmonary fibrosis post Covid-19 pandemic, I believe there is a need to study antifibrotics in post Covid-19 pulmonary fibrosis.
This treatment is already happening off label in some countries out of despair from lack of other useful interventions for this complication.

FDA has also approved some cell or Exosome based clinical trials for some Covid-19 patients.

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