Takeaway
- In patients with idiopathic pulmonary fibrosis (IPF), the use of proton pump inhibitors (PPIs) is not associated with improved survival and reduced incidence of respiratory-related hospitalisation compared with non-use.
Why this matters
- Findings suggest that PPIs may not be as beneficial in treating IPF as suggested by some studies and conditionally recommended in treatment guidelines.
Study design
- This population-based cohort study included 3036 patients diagnosed with IPF between 2002 and 2016 using data from the UK Clinical Practice Research Datalink (CPRD).
- 1852 PPI users were matched with 1852 non-users using propensity score matching.
- Primary outcome: all-cause mortality; secondary outcomes: respiratory-related mortality and hospitalisations.
- Funding: Canadian Institutes of Health Research and Canadian Foundation for Innovation.
Key results
- Overall, 1703 deaths were reported from any cause (incidence rate, 26.7 per 100 per year; 95% CI, 25.5-28.0); 1125 (66%) deaths were related to respiratory diseases.
- Median survival was 2.8 years (range, 0-13 years), and 70% of the patients died within 5 years of IPF diagnosis.
- The adjusted HR of all-cause mortality with PPI use vs no use was 1.07 (95% CI, 0.94-1.22).
- The adjusted HR of respiratory-related mortality and hospitalisations was 1.10 (95% CI, 0.94-1.28) and 1.00 (95% CI, 0.86-1.16), respectively.
Limitations
- Possibility of misclassification of IPF.
- Lack of data on disease severity or laboratory tests related to pulmonary function.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.