Patients with idiopathic pulmonary fibrosis (IPF) have a high risk of developing other health conditions, according to results of a study presented at the annual meeting of the American College of Chest Physicians (CHEST 2016), held in Los Angeles Oct. 22-26.
The results were presented under the title “Longitudinal Changes in Comorbidity Rates in Patients With Idiopathic Pulmonary Fibrosis: Analysis of Medicare Data,” by a research team led by John Stauffer and Karina Raimundo from Genentech.
To evaluate the incidence of other health conditions among IPF patients, researchers followed a Medicare population of 13,615 IPF patients and age- and gender-matched controls. Patients had at least 65 years (mean age 78.9 years) and lacked indication of a non-IPF lung disease after the last observed IPF claim compared with healthy controls. Patients were followed for at least one year and up to four years after diagnosis. The existence of other health conditions was recorded at baseline and at one and four years after the IPF diagnosis.
Patients with IPF had significantly more chronic conditions and higher Charlson Comorbidity Index (an indicator of the presence of other diseases) at baseline compared with controls. Also, at baseline, the rates for all diseases analyzed were significantly higher among patients with IPF than among healthy subjects, namely chronic obstructive pulmonary disease (COPD) including emphysema, bacterial pneumonia, gastroesophageal reflux, obstructive sleep apnea, obesity, lung cancer, pneumothorax and cardiovascular conditions.
Compared to baseline, at one year after diagnosis, the incidence of other health diseases increased progressively among patients with IPF, and even more at four years after IPF diagnosis:
- COPD including emphysema (one year: 61.1% among IPF patients versus 16.5% among controls; four years: 72.4% versus 26.9%)
- bacterial pneumonia (one year: 38.4% versus 9.8%; four years: 55.6% versus 21.4%)
- gastroesophageal reflux (one year: 33.9% versus 18.5%; four years: 48.3% versus 33.8%)
- obstructive sleep apnea (one year: 11.7% versus 3.2%; four years: 17.3% versus 6.8%)
- obesity (one year: 8.2% versus 4.3%; four years: 14.4% versus 10.3%)
- lung cancer (one year: 5.6% versus 2.2%; four years: 8% versus 3.7%)
- pneumothorax (one year: 0.5% versus 0.1%; four years: 2.2% versus 0.8%)
- cardiovascular conditions (one year: 74.3% versus 46.4%; four years: 84.6% versus 61.7%).
The results obtained with this Medicare cohort of IPF patients showed that IPF is associated with a greater risk of developing other health conditions compared to healthy individuals, and that more patients will develop certain diseases as IPF progresses.
According to the authors, the development of other health conditions among “newly diagnosed and surviving patients with IPF should be taken into consideration in their overall clinical management plan.”