Diffuse Lung Disease: Evaluation and Treatment of ILD |

Mortality Risk of Patients With Idiopathic Pulmonary Fibrosis FREE TO VIEW

Karina Raimundo, MS; Michael Broder, MD; Eunice Chang, PhD; Elya Papoyan, MPH; Ioana Popescu, MD; Sheila Reddy, PhD; John Stauffer, MD
Author and Funding Information

Genentech, Inc., South San Francisco, CA

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):484A. doi:10.1016/j.chest.2016.08.498
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SESSION TITLE: Evaluation and Treatment of ILD

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Idiopathic pulmonary fibrosis (IPF) is a debilitating, progressive, unpredictable and fatal fibrotic lung disease requiring early intervention to improve outcomes. The objective of this study was to understand the mortality risk of patients with IPF compared with matched controls in the Medicare population.

METHODS: This retrospective analysis of the Medicare database included elderly patients in the United States (aged ≥ 65 years) who were newly diagnosed with IPF in 2010 (ICD-9-CM code 516.3) and who lacked indication of a non-IPF interstitial lung disease after the last observed IPF claim. Patients with IPF were matched 1:1 (by age, sex and region) and compared with non-IPF controls from the 5% sample data set. Medicare plan enrollment was continuous the year before diagnosis (index date). Mortality risk was compared between IPF and non-IPF controls. Patients were followed for ≤ 4 years after index; ≥ 1 year of continuous Medicare plan enrollment was required post-index unless patients died within 1 year.

RESULTS: A total of 13,615 patients with IPF and their matched controls were identified. Mean age (SD) overall was 78.9 years (7.1); 50.3% were men. A significantly higher proportion of patients with IPF died 1 year post-index compared with controls (3613 patients [26.5%] vs. 1853 patients [13.6%]; P < 0.001). Similarly, in the 4-year post-index period, the mortality rate was significantly higher in patients with IPF vs. controls (7236 vs. 3647 deaths; adjusted mortality, 0.236 vs. 0.096 deaths per person-year; P < 0.001). The 25th percentile of survival time for patients with IPF and controls was 0.91 years (95% CI, 0.87, 0.95) and 3.00 years (95% CI, 2.85, 3.15), respectively. The median post-index survival was 3.06 years (95% CI, 2.96, 3.13) for patients with IPF and was not yet reached among controls (P < 0.001).

CONCLUSIONS: Medicare patients with IPF had a median survival of ≈ 3 years, which was significantly lower than their matched, non-IPF counterparts.

CLINICAL IMPLICATIONS: This study confirms the rapid, progressive decline of patients with IPF within a few years of diagnosis when they received standard-of-care treatment prior to approval of anti-fibrotic therapies, and highlights the importance of using therapies that slow disease progression and delay death. Future observational studies are needed to assess the impact of anti-fibrotic therapies on overall survival in IPF.

DISCLOSURE: Karina Raimundo: Employee: Genentech, Inc. Michael Broder: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech Eunice Chang: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech Elya Papoyan: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech Ioana Popescu: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech Sheila Reddy: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech John Stauffer: Employee: Genentech, Inc.

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