Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a well-characterised interstitial lung disease. Typically, IPF diagnosis is delayed due to nonspecific symptoms, but can also be delayed due to treatment attempts on false indication or due to treatment targeting common comorbidities. This observational study aimed to assess the dynamics in the medication and diagnosis patterns in the period before and after an IPF diagnosis.
Methods We identified all Danish patients with IPF between 2002 and 2017. We evaluated new and ongoing drug treatments and incident diagnoses 36 months before and 12 months after an IPF diagnosis by use of Danish nationwide registries. To aid interpretation, 10 random controls were recruited for each case.
Results A total of 650 IPF patients were identified (median age 73 years (interquartile range 65–78), 70.3% males). Prior to the IPF diagnosis, the most prevalent diagnoses were dyspnoea and non-IPF interstitial lung diseases. For drug use, IPF patients had higher initiation rates for antibiotics, oral corticosteroids and mucolytics. In terms of drug volume, IPF patients used more respiratory drugs, antibiotics, immunosuppressants, corticosteroids, proton pump inhibitors, benzodiazepines and opium alkaloids within the 6 months preceding their IPF diagnosis, compared to the controls. Overall drug use decreased after an IPF diagnosis, mainly due to a reduced glucocorticoid and cardiovascular drug use.
Conclusion Among IPF patients, an increased drug use was observed for diagnoses with symptoms overlapping those of IPF, particularly this was observed during the last 6 months before an IPF diagnosis. This emphasises the need for an increased IPF awareness.
Abstract
Among IPF patients, an increased drug use was observed for diagnoses with symptoms overlapping those of IPF. Particularly this was observed during the last 6 months before an IPF diagnosis. This emphasises the need for an increased IPF awareness. https://bit.ly/3bAzveS
Footnotes
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Author contributions: J.R. Davidsen and D.P. Henriksen developed the concept, and designed the study together with L.C. Lund, C.B. Laursen and J. Hallas. J. Hallas collected data. L.C. Lund and D.P. Henriksen performed statistical analyses. J.R. Davidsen, L.C. Lund, C.B. Laursen, J. Hallas and D.P. Henriksen helped with data interpretation, and provided input for and critical revision of the manuscript. All authors had full access to all data and statistical reports. J.R. Davidsen drafted the initial manuscript. All authors reviewed and edited drafts, and approved the final version for submission. J.R. Davidsen is the guarantor.
Conflict of interest: J.R. Davidsen reports grants and personal fees from Roche, and personal fees and nonfinancial support from Boehringer Ingelheim, outside the submitted work.
Conflict of interest: L.C. Lund reports participation in research projects funded by Menarini Pharmaceutical and LEO Pharma, with funds paid to the institution where he was employed (no personal fees) and with no relation to the work reported in this paper.
Conflict of interest: C.B Laursen has nothing to disclose.
Conflict of interest: J. Hallas has nothing to disclose.
Conflict of interest: D.P. Henriksen has nothing to disclose.
- Received July 8, 2020.
- Accepted August 28, 2020.
- Copyright ©ERS 2020
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