Sex Differences in the Incidence and Outcomes of Patients Hospitalized by Idiopathic Pulmonary Fibrosis (IPF) in Spain from 2016 to 2019

Abstract

(1) Background: To assess sex differences in the incidence, characteristics, procedures and outcomes of patients admitted with idiopathic pulmonary fibrosis (IPF); and to analyze variables associated with in-hospital mortality (IHM). (2) Methods: We analyzed data collected by the Spanish National Hospital Discharge Database, 2016–2019. (3) Results: We identified 13,278 hospital discharges (66.4% men) of IPF (primary diagnosis 32.33%; secondary diagnosis: 67.67%). Regardless of the diagnosis position, IPF incidence was higher among men than women, increasing with age. Men had 2.74 times higher IPF incidence than women. Comorbidity was higher for men in either primary or secondary diagnosis. After matching, men had higher prevalence of pulmonary embolism and pneumonia, and women of congestive heart failure, dementia, rheumatoid disease and pulmonary hypertension. Invasive ventilation, bronchoscopy and lung transplantation were received more often by men than women. IHM was higher among men with IPF as primary diagnosis than among women and increased with age in both sexes and among those who suffered cancer, pneumonia or required mechanical ventilation. (4) Conclusions: Incidence of IPF was higher among men than women, as well as comorbidity and use of bronchoscopy, ventilation and lung transplantation. IHM was worse among men than women with IPF as primary diagnosis, increasing with age, cancer, pneumonia or mechanical ventilation use.

The Aggregate Index of Systemic Inflammation (AISI): A Novel Prognostic Biomarker in Idiopathic Pulmonary Fibrosis

“…In agreement with recent observations [ 44 , 59 ], survival was not significantly associated with sex; however, this is in contrast with other studies in which the female sex was significantly associated with a lower risk of in-hospital mortality [ 60 , 61 ]. Moreover, in contrast with other reports [ 62 , 63 ], age was not independently associated with survival. However, it should also be highlighted that this observation is in line with other studies [ 64 , 65 ].…”

Safety and tolerability of nintedanib in patients with interstitial lung diseases in subgroups by sex: a post-hoc analysis of pooled data from four randomised controlled trials

“…Previous studies have also found a worse course of disease in male patients than female patients with ILDs. 1,7,8 Based on pharmacokinetic studies in patients with IPF, age, bodyweight, smoking, and Asian race influence nintedanib exposure, within the range of interpatient variability. 25,26 Further analyses of data from patients with various ILDs showed a positive association between nintedanib exposure and the risk of liver enzyme elevations.…”

“…5,6 The most common ILD, idiopathic pulmonary fibrosis (IPF), is more common in men than women. 7 Studies in patients with various ILDs have found male sex to be associated with more severe ILDs than female sex, as indicated by increased lung function impairment and increased risk of mortality. 7,8 Nintedanib is a tyrosine kinase inhibitor that inhibits processes fundamental to the progression of pulmonary fibrosis.…”

“…7 Studies in patients with various ILDs have found male sex to be associated with more severe ILDs than female sex, as indicated by increased lung function impairment and increased risk of mortality. 7,8 Nintedanib is a tyrosine kinase inhibitor that inhibits processes fundamental to the progression of pulmonary fibrosis. 9 Nintedanib has been licensed for the treatment of fibrosing systemic sclerosis-associated ILD, IPF, and other chronic fibrosing ILDs with a progressive phenotype.…”