Prognostic impact of an early marginal decline in forced vital capacity in idiopathic pulmonary fibrosis patients treated with pirfenidone

Kono, Masato; Nakamura, Yutaro; Saito, Go; Koyanagi, Yu; Miyashita, Koichi; Tsutsumi, Akari; Kobayashi, Takeshi; Yasui, Hideki; Hozumi, Hironao; Karayama, Masato; Suzuki, Yuzo; Furuhashi, Kazuki; Miki, Yuko; Dai, Huaping; Fujisawa, Tomoyuki; Inui, Naoki; Suda, Takafumi; Nakamura, Hidenori

doi:10.1016/j.resinv.2019.07.003

Cited by 7 publications

(12 citation statements)

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“…We recently reported on an early marginal decline in FVC following treatment with PFD, which has a significant prognostic impact on IPF patients. 11 However, the impacts on survival of FVC decline prior to treatment and a slow rate of decline of FVC is not known. Furthermore, differences in the impact on survival of FVC decline following antifibrotic therapy with PFD or NTD have not also been studied.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis

Aono

Nakamura

Kono

et al. 2020

Ther Adv Respir Dis

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Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease (ILD). Currently, two antifibrotic drugs are available for reducing forced vital capacity (FVC) decline in IPF. However, many pulmonologists wait before initiating treatment, especially when IPF patients have stable disease. This study aimed to investigate the impact on survival outcome of FVC decline and a slow rate of FVC decline prior to and following treatment with these two antifibrotic drugs. Methods: Out of the 235 IPF patients treated with antifibrotic therapy that were screened, 105 cases were eligible, who then underwent physiological evaluation at 6 months prior to and following antifibrotic therapy. Clinical characteristics and prognostic outcomes were compared among groups, and prognostic factors were evaluated using a Cox proportional hazards analysis. Results: In terms of %FVC decline prior to the therapy and a slow rate of FVC decline, there was no significant difference between stable and worsened groups and responder and non-responder groups, respectively. On the other hand, in terms of %FVC decline (decline >5%) following antifibrotic therapy, the stable/improved group had significantly better prognosis than the worsened group. Prognostic analysis revealed that a stable/improved status following antifibrotic therapy [HR: 0.35 (0.15–0.87)] was significantly associated with a better prognosis. Conclusions: Concerning the FVC decline prior to and following antifibrotic therapy and a slow rate of FVC decline, only the FVC decline following the therapy is associated with a greater survival outcome. An early treatment decision may thus be beneficial for IPF. The reviews of this paper are available via the supplemental material section.

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Section: Introductionmentioning

confidence: 99%

Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis

Aono

Nakamura

Kono

et al. 2020

Ther Adv Respir Dis

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“…Among them, 1220 were excluded because they were either duplicates or irrelevant. After a full-text review of the remaining 37 articles, one was further excluded because it did not fulfill the inclusion criteria, thus leaving 36 studies (9958 IPF patients, 78% males) for final analysis [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ] ( Figure 1 ). Fourteen studies were conducted in Japan [ 22 , 27 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 43 , 45 , 50 , 51 ], nine in the USA [ 21 , 25 , 31 , …”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies were conducted in Japan [ 22 , 27 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 43 , 45 , 50 , 51 ], nine in the USA [ 21 , 25 , 31 , 38 , 41 , 46 , 47 , 48 , 49 ], three in France [ 44 , 53 , 54 ], three in Italy [ 26 , 52 , 56 ], three in China [ 28 , 39 , 42 ], two in South Korea [ 24 , 55 ], one in Ireland [ 23 ], and one in Saudi Arabia [ 40 ]. The reported clinical endpoints included mortality in 21 studies [ 21 , 22 , 23 , 24 , 26 , 29 , 30 , 32 , 33 , 37 , 38 , 39 , 40 , 45 , 49 , 50 , 52 , 53 , 54 , …”

Section: Resultsmentioning

confidence: 99%

“…The reported clinical endpoints included mortality in 21 studies [ 21 , 22 , 23 , 24 , 26 , 29 , 30 , 32 , 33 , 37 , 38 , 39 , 40 , 45 , 49 , 50 , 52 , 53 , 54 , 55 , 56 ], disease exacerbation in 11 [ 22 , 23 , 25 , 27 , 28 , 31 , 34 , 37 , 41 , 46 , 55 ], disease progression in five [ 42 , 43 , 44 , 47 , 54 ], hospitalization in three [ 48 , 53 , 54 ], tolerability to the antifibrotic agent nintedanib in three [ 35 , 36 , 51 ], and incident pneumothorax in one [ 32 ]. Ten studies were prospective [ 25 , 26 , 27 , 28 , 30 , 43 , 44 , 46 , 53 , 54 ], while the remaining 26 were retrospective [ …”

Section: Resultsmentioning

confidence: 99%

“…Twenty-nine studies assessed the BMI as a continuous variable [ 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 37 , 39 , 40 , 41 , 43 , 45 , 46 , 47 , 48 , 51 , 52 , 53 , 54 , 55 , 56 ], six used cut-off values [ 24 , 36 , 38 , 42 , 44 , 49 ], and one assessed both [ 50 ]. Twenty-six out of 36 studies were published over the last five years [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , …”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of the Prognostic Significance of the Body Mass Index in Idiopathic Pulmonary Fibrosis

Zinellu

Carru

Pirina

et al. 2023

JCM

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The identification of novel prognostic biomarkers might enhance individualized management strategies in patients with idiopathic pulmonary fibrosis (IPF). Although several patient characteristics are currently used to predict outcomes, the prognostic significance of the body mass index (BMI), a surrogate measure of excess fat mass, has not been specifically investigated until recently. We systematically searched PubMed, Web of Science, and Scopus, from inception to July 2022, for studies investigating associations between the BMI and clinical endpoints in IPF. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the risk of bias. The PRISMA 2020 statement on the reporting of systematic reviews was followed. Thirty-six studies were identified (9958 IPF patients, low risk of bias in 20), of which 26 were published over the last five years. Significant associations between lower BMI values and adverse outcomes were reported in 10 out of 21 studies on mortality, four out of six studies on disease progression or hospitalization, and two out of three studies on nintedanib tolerability. In contrast, 10 out of 11 studies did not report any significant association between the BMI and disease exacerbation. Our systematic review suggests that the BMI might be useful to predict mortality, disease progression, hospitalization, and treatment-related toxicity in IPF (PROSPERO registration number: CRD42022353363).

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A secure and light‐weight patient survival prediction in Internet of Medical Things framework

Mittal,

Chawla,

Rahman

et al. 2024

Int J Network Mgmt

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SummaryThoracic surgeries in major lung resections for primary lung cancer are fraught with potential risks, emphasising the need to understand factors contributing to postoperative mortality. This study investigates the interplay of objective and subjective data in predicting postoperative outcomes to reduce data transmission costs in the Internet of Medical Things (IoMT). Objective metrics, such as forced vital capacity (FVC), offer consistent, quantifiable insights essential for predictive modelling. Conversely, subjective data derived from patient self‐reports suggest that the patient's personal experiences are crucial for assessing the quality of life postsurgery. Utilising a dataset from the University of California, Irvine's Machine Learning Repository (UCI), 17 distinct attributes were examined. Using ensemble learning classifiers, the extra trees classifier is superior when utilising all features, achieving an accuracy of 0.92. Combining select subjective features, specifically PRE6, PRE8 and AGE (demographic), with objective data, yielded a comparable accuracy of 0.91. Feature importance analysis further highlights the significance of features like PRE5, PRE4 and AGE. This suggests potential redundancies in the full feature set, emphasising the importance of feature selection. Importantly, when compared with existing literature, this study's findings offer insights into the future of predictive modelling in thoracic surgeries, with implications for the rapidly evolving field of the IoMT.

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Prognostic impact of an early marginal decline in forced vital capacity in idiopathic pulmonary fibrosis patients treated with pirfenidone

Cited by 7 publications

References 27 publications

Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis

Prognostic significance of forced vital capacity decline prior to and following antifibrotic therapy in idiopathic pulmonary fibrosis

A Systematic Review of the Prognostic Significance of the Body Mass Index in Idiopathic Pulmonary Fibrosis

A secure and light‐weight patient survival prediction in Internet of Medical Things framework

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