01.12.2019 | Research article | Ausgabe 1/2019 Open Access

Antifibrotic treatment response and prognostic predictors in patients with idiopathic pulmonary fibrosis and exposed to occupational dust
- Zeitschrift:
- BMC Pulmonary Medicine > Ausgabe 1/2019
Electronic supplementary material
Publisher’s Note
Background
Methods
Study design and subjects
Measurements
Sociodemographic and clinical features
Occupational exposure
Lung function
Prognostic predictors
Initiation of long-term oxygen therapy (LTOT)
Data analysis
Results
Baseline characteristics of the study population
Variables
a
|
Exposed
(
n = 62)
|
Not exposed
(
n = 53)
|
p
|
---|---|---|---|
Male gender, %
|
79.0
|
69.8
|
0.21
|
Mean age, years (SD)
|
69.6 (7.3)
|
68.7 (8.7)
|
|
Mean age at symptoms onset (SD)
|
68.2 (7.9)
|
67.7 (9.1)
|
|
Mean time-span between symptoms onset and diagnosis, months (SD)
|
15.7 (17.3)
|
17.8 (25.0)
|
|
Educational level, %
|
|||
-Primary/secondary school
|
50.1
|
28.3
|
|
-High school
|
30.6
|
17.0
|
|
-University degree
|
19.3
|
54.7
|
0.04
|
Mean BMI, kg/m
2 (SD)
|
28.0 (4.3)
|
28.1 (4.1)
|
|
Smoking status:
|
|||
-Cigarette smoke (current or former), %
|
75.8
|
67.9
|
|
-Mean Pack/year (SD)
|
25.6 (24.0)
|
24.9 (27.8)
|
|
Comorbidities %
|
|||
-None
|
11.3
|
3.8
|
|
-GERD
|
24.2
|
11.3
|
|
-Cancer
|
6.5
|
13.2
|
|
-Respiratory diseases
|
9.6
|
15.1
|
|
-Cardiovascular diseases
|
40.3
|
30.1
|
|
-Others
|
9.1
|
26.5
|
|
Family history of IPF, %
|
9.7
|
9.4
|
|
mMRC Breathlessness Scale grade
b, %
|
|||
-Grade 0
|
4.8
|
9.3
|
|
-Grade 1
|
21.0
|
18.9
|
|
-Grade 2
|
32.3
|
43.4
|
|
-Grade 3
|
29.0
|
22.6
|
|
-Grade 4
|
12.9
|
5.7
|
|
Exposure to asbestos, %
|
46.8
|
18.9
|
0.002
|
Mean duration of asbestos exposure, years (SD)
|
8.9 (12.4)
|
5.8 (13.6)
|
|
Mean WHODAS 2.0 score (SD)
|
24.7 (18.6)
|
20.8 (19.2)
|
|
Mean HADS-A score (SD)
|
5.9 (3,2)
|
6.2 (3.5)
|
|
Mean HADS-D score (SD)
|
7.0 (3.1)
|
5.6 (3.4)
|
|
Pharmacological treatment, %
|
|||
-None
|
16.1
|
7.6
|
|
-Pirfenidone
|
46.8
|
50.9
|
|
-Nintedanib
|
37.1
|
41.5
|
Pulmonary function tests and prognostic indices
Variables
a
|
Exposed
(
n = 46)
b
|
Not exposed
(
n = 43)
b
|
||
---|---|---|---|---|
Baseline assessment
|
12-month assessment
|
Baseline assessment
|
12-month assessment
|
|
Mean FEV
1, L (SD)
|
2.2 (0.5)
|
2.1 (0.5)
|
2.1 (0.6)
|
2.1 (0.6)
|
Mean FEV
1, % predicted (SD)
|
89.9 (21.2)
|
86.8 (19.9)
|
84.3 (20.3)
|
80.8 (19.2)
|
Mean FVC, L (SD)
|
2.6 (0.6)
|
2.5 (0.6)
|
2.5 (0.8)
|
2.4 (0.8)
|
Mean FVC, % predicted (SD)
|
84.0 (19.7)
|
80.5 (17.8)
|
76.7 (18.5)
|
73.7 (18.6)
|
Mean DLCO, % predicted (SD)
|
49.4 (14.7)
|
44.8 (18.0)
|
47.7 (12.2)
|
45.6 (13.3)
|
Mean TLC, L (SD)
|
4.5 (1.1)
|
4.3 (1.1)
|
4.2 (1.2)
|
4.1 (1.1)
|
Mean TLC, % predicted (SD)
|
76.1 (16.9)
|
71.4 (15.7)
|
71.8 (14.6)
|
67.6 (15.9)
|
GAP score, %
|
||||
- 0–3 (IPF stage I)
|
40.9
|
31.8
|
40.5
|
36.6
|
- 4–5 (IPF stage II)
|
47.7
|
47.7
|
52.4
|
46.3
|
- 6–8 (IPF stage III)
|
11.4
|
20.5
|
7.1
|
17.1
|
Mean GAP score (SD)
|
3.8 (1.3)
|
4.0 (1.5)
|
3.7 (1.2)
|
4.0 (1.5)
|
Mean IPF stage (SD)
|
1.7 (0.7)
|
1.9 (0.7)
|
1.7 (0.6)
|
1.8 (0.7)
|
Mean CPI score (SD)
|
44.9 (12.3)
|
50.1 (15.1)
|
47.4 (9.9)
|
49.1 (11.1)
|
Variables
|
FVC% pred.
1-year after treatment
|
DLCO% pred.
1-year after treatment
|
||
---|---|---|---|---|
Adjusted coeff.
(95% CI)
|
p
|
Adjusted coeff.
(95% CI)
|
p
|
|
Mean age at symptoms onset, 10-year increase
|
−0.04 (− 0.12; 0.03)
|
0.2
|
0.17 (− 0.08; 0.43)
|
0.2
|
Male gender
|
0.44 (0.25; 0.63)
|
< 0.001
|
3.11 (−3.45; 9.69)
|
0.3
|
Mean BMI, 10-point increase
|
−0.08 (− 0.25; 0.09)
|
0.3
|
0.04 (− 0.52; 0.61)
|
0.9
|
Smoking status:
|
||||
-Cigarette smoke, yes vs no
|
0.13 (−0.01; 0.27)
|
0.07
|
−1.34 (−5.62; 2.94)
|
0.5
|
-Mean pack/year, 10-unit increase
|
−0.01 (− 0.04; 0.02)
|
0.5
|
− 0.15 (− 1.17; 0.88)
|
0.8
|
History of GERD, yes vs no
|
0.09 (− 0.06; 0.26)
|
0.3
|
0.98 (−4.61; 6.58)
|
0.7
|
Familiar history of IPF, yes vs no
|
0.00 (−0.21; 0.20)
|
0.9
|
2.75 (−3.84; 9.34)
|
0.4
|
Exposed vs not exposed
a
|
0.06 (−0.06; 0.19)
|
0.3
|
1.17 (−3.01; 5.17)
|
0.6
|
Mean duration of exposure, 10-y increase
|
−0.00 (− 0.03; 0.03)
|
0.9
|
− 0.01 (− 0.12; 0.09)
|
0.8
|
Asbestos exposure, yes vs no
|
− 0.04 (− 0.17; 0.09)
|
0.6
|
−2.76 (− 7.25; 1.73)
|
0.2
|
FVC % predicted, 1% increase
|
||||
-Baseline FVC
|
0.01 (0.01; 0.02)
|
< 0.001
|
−1.96 (−6.47; 2.54)
|
0.4
|
-Pre-therapy FVC
|
0.02 (0.01; 0.02)
|
< 0.001
|
−0.09 (− 0.23; 0.05)
|
0.2
|
DLCO % predicted, 1% increase
|
||||
-Baseline DLCO
|
0.00 (−0.01; 0.01)
|
0.3
|
0.73 (0.52; 0.94)
|
< 0.001
|
-Pre-therapy DLCO
|
0.00 (−0.00; 0.01)
|
0.5
|
0.71 (0.51; 0.91)
|
< 0.001
|
mMRC Breathlessness Scale grade, 1-grade increase
|
−0.01 (− 0.08; 0.06)
|
0.7
|
−1.31 (−3.57; − 0.95)
|
0.3
|
Initiation of long-term oxygen therapy (LTOT) and deaths
Variables
|
Oxygen therapy HR (95% CI)
|
p
|
---|---|---|
Exposed vs not exposed
a
|
0.63 (0.28–1.40)
|
0.3
|
Mean pack/year, 10-unit increase
|
1.17 (0.98–1.39)
|
0.09
|
FEV
1, L 1-unit increase
|
0.38 (0.17–0.85)
|
0.020
|
GAP score, 1-level increase
|
1.89 (1.30–2.76)
|
0.001
|
CPI score, 1-level increase
|
1.07 (1.02–1.12)
|
0.008
|