Association between weight loss and decline in FVC in patients with IPF
2019
Costabel, U | Crestani, Bruno | Cottin, Vincent | Thibault, Ronan | Lederlin, Mathieu | Vernhet, Laurent | Stansen, Wibke | Quaresma, Manuel | Jouneau, Stephane | Ruhrlandklinik University Hospital | AP-HP - Hôpital Bichat - Claude Bernard [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL] ; Hôpital Louis Pradel [CHU - HCL] ; Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL) | Université de Lyon | Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou] | Nutrition, Métabolismes et Cancer (NuMeCan) ; Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Boehringer Ingelheim Pharma GmbH & Co. KG | Institut de recherche en santé, environnement et travail (Irset) ; Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes (Biosit : Biologie - Santé - Innovation Technologique)
International audience
Show more [+] Less [-]English. IntroductionWeight loss has been associated with worse survival in patients with idiopathic pulmonary fibrosis (IPF).AimTo assess the association between weight loss and disease progression measured as decline in forced vital capacity (FVC) in patients with IPF in the INPULSIS trials.MethodsIn post-hoc analyses, we assessed the rate of decline in FVC (mL/yr) over 52 weeks in subgroups by weight loss from baseline over 52 weeks (weight gain/no weight loss; 0 to ≤ 5% weight loss; > 5 to ≤ 10% weight loss; > 10% weight loss) using random coefficient regression.ResultsAmong 421 patients in the placebo group, the proportions with no, 0 to ≤ 5%, > 5 to ≤ 10% and > 10% weight loss over 52 weeks were 45.6%, 34.7%, 13.1% and 6.7%, respectively. At baseline, subgroups with greater weight loss over 52 weeks had a higher mean age, lower proportion of males, lower mean DLco % predicted and lower mean FVC % predicted. In the placebo group, the mean rate of decline in FVC over 52 weeks increased with increasing weight loss ([Fig. 1]). In contrast, similar rates of decline in FVC were observed in nintedanib-treated patients (n = 635) irrespective of weight loss.ConclusionIn the INPULSIS trials, patients with greater weight loss showed faster disease progression when treated with placebo, and a more pronounced treatment effect of nintedanib.
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