Author(s): Davies S.; Holt A.; Menzies D.; Sutcliffe J.; Agnew S.; Spencer L.G.
Source: Thorax; Dec 2017; vol. 72
Publication Date: Dec 2017
Publication Type(s): Conference Abstract
Available at Thorax – from BMJ Journals – NHS
Abstract:Introduction Antifibrotic medication (AFM) is indicated for the treatment of idiopathic pulmonary fibrosis (IPF), but medication related side effects can lead to early discontinuation of therapy in some patients. Factors that may predict intolerance of AFM are poorly described Methods Retrospective data from all patients from a single District General Hospital that had received AFM for IPF between January 2014 and March 2017 were analysed. Patients were defined at four months as either tolerant or intolerant of AFM determined by either continuation of treatment, or discontinuation of treatment because of medication related side effects respectively. Fisher’s exact test was used to compare age, body mass index (BMI) and Clinical Frailty Score (CFS) between the two groups. Frailty was defined as a CFS of >=6 (scale 1-9 with a high score indicating greater frailty) Results 35 patients received AFM and 10 (29.4%) were intolerant of treatment at 4 months. Patients without frailty were more likely to be tolerant of treatment than those with frailty (86.4% versus 33.3%, p=.0074) Patients with a BMI in the upper three quartiles of the sample were more likely to be tolerant of treatment than those in the lowest quartile, but this trend did not reach statistical significance (80.7% versus 44.4%, p=0.081), and there was no difference in tolerance between patients over 80 years of age and younger patients (77.8% versus 75.0%, p>=0.99) Conclusions Frailty and low BMI may predict treatment intolerance with AFM in IPF, whereas age does not appear to influence this outcome. Clinicians should consider a patient’s frailty when considering this therapy. Further analysis of a larger dataset and a prospective study are warranted.