Deborah Assayag1, Kristopher Garlick2, Kerri A Johannson3, Charlene D Fell4, Martin Kolb5, Gerard Cox6, Nathan Hambly7, Helene Manganas8, Julie Morisset9, Jolene H Fisher10, Shane Shapera11, Andrea S Gershon12,13, Teresa To14, Mohsen Sadatsafavi15, Pearce G Wilcox16, Andrew J Halayko17,18, Nasreen Khalil19, Christopher J Ryerson19. 1. McGill University, 5620, Medicine, Montreal, Quebec, Canada; deborah.assayag@mcgill.ca. 2. Boehringer Ingelheim Canada Ltd, 4439, Burlington, Ontario, Canada. 3. University of Calgary, 2129, Medicine, Calgary, Alberta, Canada. 4. University of Calgary, 2129, Department of Medicine, Calgary, Alberta, Canada. 5. McMaster University, Hamilton, Ontario, Canada. 6. St. Joseph's Hospital, Hamilton, Ontario, Canada. 7. McMaster University, Medicine/ Respirology, Hamilton, Ontario, Canada. 8. Centre Hospitalier de l'Université de Montréal, Département de Médecine, Montreal, Quebec, Canada. 9. Centre Hospitalier de l'Universite de Montreal, 25443, Medecine, Montreal, Quebec, Canada. 10. University of Toronto, Medicine, Toronto, Ontario, Canada. 11. University Health Network, 7989, Medicine, Toronto, Ontario, Canada. 12. Sunnybrook Research Institute, 282299, Toronto, Ontario, Canada. 13. ICES, Toronto, Ontario, Canada. 14. The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, Ontario, Canada. 15. University of British Columbia, Vancouver, British Columbia, Canada. 16. St Paul's Hospital, Vancouver, British Columbia, Canada. 17. University of Manitoba, 8664, SECTION OF RESPIRATORY DISEASES, Winnipeg, Manitoba, Canada. 18. University of Manitoba, 8664, Biology of Breathing Group, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada. 19. University of British Columbia, Medicine, Vancouver, British Columbia, Canada.
Abstract
RATIONALE: Real-life pharmacological treatment patterns of patients with interstitial lung diseases (ILD) remain elusive. OBJECTIVES: The objective of this study was to determine how often and with what medications patients with ILD are treated in Canadian tertiary care clinics. METHODS: All patients with ILD prospectively enrolled in the Canadian Registry for Pulmonary Fibrosis were included in this observational study. All first instances of medication for each patient were compiled. Time between the diagnosis of ILD and the first initiation of an ILD-related medication was compared across diagnostic categories. Cox proportional hazards models were used to identify variables associated with time-to-treatment initiation, stratified by diagnostic category. RESULTS: Out of 2,652 patients, a total of 1,483 (56%) were treated with an ILD-related medication during the median follow-up of 3.0 years (1.4 to 5.9), including 349/646 (54%) patients with idiopathic pulmonary fibrosis (IPF) who received an antifibrotic. Patients with IPF were treated earlier and in greater proportion compared to those with non-IPF ILD (p=0.001). Male sex and lower lung function were associated with shorter time to treatment initiation in the full cohort. CONCLUSIONS: Overall, 56% of patients with ILD seen across seven Canadian specialized ILD clinics received pharmacological treatment over a median follow-up of 3 years. Further studies are needed to assess longitudinal patterns of treatment and their influence on key outcomes.
RATIONALE: Real-life pharmacological treatment patterns of patients with interstitial lung diseases (ILD) remain elusive. OBJECTIVES: The objective of this study was to determine how often and with what medications patients with ILD are treated in Canadian tertiary care clinics. METHODS: All patients with ILD prospectively enrolled in the Canadian Registry for Pulmonary Fibrosis were included in this observational study. All first instances of medication for each patient were compiled. Time between the diagnosis of ILD and the first initiation of an ILD-related medication was compared across diagnostic categories. Cox proportional hazards models were used to identify variables associated with time-to-treatment initiation, stratified by diagnostic category. RESULTS: Out of 2,652 patients, a total of 1,483 (56%) were treated with an ILD-related medication during the median follow-up of 3.0 years (1.4 to 5.9), including 349/646 (54%) patients with idiopathic pulmonary fibrosis (IPF) who received an antifibrotic. Patients with IPF were treated earlier and in greater proportion compared to those with non-IPF ILD (p=0.001). Male sex and lower lung function were associated with shorter time to treatment initiation in the full cohort. CONCLUSIONS: Overall, 56% of patients with ILD seen across seven Canadian specialized ILD clinics received pharmacological treatment over a median follow-up of 3 years. Further studies are needed to assess longitudinal patterns of treatment and their influence on key outcomes.
Authors: Vincent Cottin; Fernando J Martinez; R Gisli Jenkins; John A Belperio; Hideya Kitamura; Maria Molina-Molina; Inga Tschoepe; Carl Coeck; Dirk Lievens; Ulrich Costabel Journal: Respir Res Date: 2022-04-07