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  • 1
    Online Resource
    Online Resource
    Incidence of the Pneumoconioses in the United Kingdom General Population between 1997 and 2008
    S. Karger AG ; 2012
    In:  Respiration Vol. 84, No. 3 ( 2012), p. 200-206
    Details
    In: Respiration, S. Karger AG, Vol. 84, No. 3 ( 2012), p. 200-206
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The incidence of the pneumoconioses in the UK is primarily estimated using occupational-based registries and disability pension schemes. These sources indicate a downward trend in the incidence of the pneumoconioses from 1995 onwards. There are no previously published general population-based observational studies quantifying the incidence of the pneumoconioses in the UK. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 The aim of this study was to investigate the incidence of the pneumoconioses in the UK general population between 1997 and 2008 using data from the General Practice Research Database (GPRD). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Data from the UK-based GPRD were used to estimate the incidence of pneumoconioses over a 12-year period (1997–2008). Crude incidence rates for asbestosis and non-asbestos-related pneumoconioses were stratified by gender, age group and calendar period, and rate ratios were adjusted using Poisson regression. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The majority of cases was diagnosed with asbestosis, and the overall, crude incidence density for this pneumoconiosis during the 12-year study period was 2.7 (95% confidence interval 2.5–2.9) per 100,000 person-years. The incidence increased progressively during the period 1997–2005 and then decreased slightly during the period 2006–2008, even after controlling for the strong effect of an ageing UK population. The non-asbestos-related pneumoconioses, in contrast to asbestosis, showed a progressive reduction in incidence from 2003 onwards. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 This study demonstrates that the pneumoconioses remain an important public health issue and, furthermore, documents an overall increase in asbestosis incidence in the UK between 1997 and 2008.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000338116
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
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  • 2
    Online Resource
    Online Resource
    Metformin Does Not Affect Clinically Relevant Outcomes in Patients with Idiopathic Pulmonary Fibrosis
    S. Karger AG ; 2018
    In:  Respiration Vol. 96, No. 4 ( 2018), p. 314-322
    Details
    In: Respiration, S. Karger AG, Vol. 96, No. 4 ( 2018), p. 314-322
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Diabetes mellitus is a possible risk factor for the development of idiopathic pulmonary fibrosis (IPF), yet the effect of antidiabetic therapy on the course of IPF is unknown. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 This post hoc analysis assessed the effect of metformin on clinically relevant outcomes in patients with IPF. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 For the primary analysis, patients randomized to placebo ( 〈 i 〉 n 〈 /i 〉 = 624) in 3 phase 3, double-blind, controlled trials of pirfenidone (CAPACITY [NCT00287716 and NCT00287729]; ASCEND [NCT01366209] ) were categorized by baseline metformin use. The primary outcome was disease progression (forced vital capacity [FVC] decline ≥10%, 6-min walking distance [6MWD] decline ≥50 m, or death). Other outcomes included mortality, hospitalization, FVC decline (≥10 and ≥5%), and 6MWD decline. Outcomes were also assessed in patients with diabetes and/or hyperglycemia (impaired glucose tolerance [IGT] and diabetes population [IGT-diabetes population] ) and all patients included in the 3 studies (intention-to-treat [ITT] population). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Overall, 71 (11.4%) patients were metformin users and 553 (88.6%) were nonmetformin users. Baseline data were similar between groups, except for a higher percentage of males (84.5 vs. 73.2%) and a history of diabetes (98.6 vs. 11.6%) in metformin users versus nonmetformin users. The unadjusted 1-year analyses demonstrated no significant differences in disease progression or other outcomes. A higher proportion of metformin users compared with nonmetformin users had a relative FVC decline of ≥5% (63.4 vs. 50.6%, 〈 i 〉 p 〈 /i 〉 = 0.043). Results were similar for the IGT-diabetes population and for the ITT population. Multivariable analyses yielded similar results. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Metformin has no effect on clinically relevant outcomes in patients with IPF.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000489668
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
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  • 3
    Online Resource
    Online Resource
    Identifying Barriers to Idiopathic Pulmonary Fibrosis Treatment: A Survey of Patient and Physician Views
    S. Karger AG ; 2018
    In:  Respiration Vol. 96, No. 6 ( 2018), p. 514-524
    Details
    In: Respiration, S. Karger AG, Vol. 96, No. 6 ( 2018), p. 514-524
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Antifibrotics are recommended for the treatment of individuals with idiopathic pulmonary fibrosis (IPF), but treatment use remains at ∼60%. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To investigate the views of individuals with IPF and pulmonologists on the diagnosis and management of IPF to understand treatment patterns. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Interviews and/or online surveys were completed by patients and pulmonologists from Canada, France, Germany, Italy, Spain, and the UK. Responses from physicians were analyzed by time between diagnosis and treatment initiation in the majority of patients with IPF (group A, & #x3e; 4 months; group B, ≤4 months). Statistical comparisons between physicians were undertaken using 〈 i 〉 z 〈 /i 〉 tests, with 〈 i 〉 p 〈 /i 〉 & #x3c; 0.05 considered statistically significant. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The physicians in group A saw fewer patients, were less comfortable discussing the IPF prognosis with patients, and had less belief in the benefits of antifibrotic treatments than the physicians in group B. These physicians’ attitudes contrasted with those of the patients, who wanted more information about the IPF prognosis and pharmacological treatment options at diagnosis and were more concerned about preventing disease progression than avoiding medication side effects. Differences between countries were found regarding physicians’ comfort in discussing the prognosis at diagnosis and access to care. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Several barriers to antifibrotic treatment, principally reflecting the differing views and values of patients and physicians, were identified in this study, suggesting a need for better patient-physician communication about pharmacological therapy for IPF.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000490667
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
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  • 4
    Online Resource
    Online Resource
    Antacid Therapy and Disease Progression in Patients with Idiopathic Pulmonary Fibrosis Who Received Pirfenidone
    S. Karger AG ; 2017
    In:  Respiration Vol. 93, No. 6 ( 2017), p. 415-423
    Details
    In: Respiration, S. Karger AG, Vol. 93, No. 6 ( 2017), p. 415-423
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Gastroesophageal reflux disease is a potential risk factor for idiopathic pulmonary fibrosis (IPF) progression; however, the impact of antacid therapy (AAT) is under debate. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To evaluate the effect of AAT on IPF progression in pirfenidone-treated patients. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This post hoc analysis included patients with IPF who received pirfenidone in 3 trials (CAPACITY [PIPF-004/PIPF-006] and ASCEND [PIPF-016] ). Pulmonary function, exercise tolerance, survival, hospitalizations, and adverse events (AEs) over 52 weeks were analyzed by baseline AAT use. Disease progression was defined as a decrease in forced vital capacity (FVC) of ≥10%, a decrease in 6-min walking distance of ≥50 m, or death over 1 year. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 623 patients, 44% received AAT. No significant differences were found at 52 weeks (AAT versus non-AAT, respectively) in disease progression (24.9 vs. 30.6%; 〈 i 〉 p 〈 /i 〉 = 0.12), all-cause mortality rate (2.9 vs. 4.0%; 〈 i 〉 p 〈 /i 〉 = 0.47), IPF-related mortality rate (1.1 vs. 2.0%; 〈 i 〉 p 〈 /i 〉 = 0.37), all-cause hospitalization rate (16.1 vs. 18.3%; 〈 i 〉 p 〈 /i 〉 = 0.48), or mean change in percent FVC (-2.7 vs. -3.1%; 〈 i 〉 p 〈 /i 〉 = 0.44). A relative, but not absolute, FVC decline of ≥10% favored AAT (15 vs. 22%; 〈 i 〉 p 〈 /i 〉 = 0.03). Severe gastrointestinal AEs (3.7 vs. 0.9%; 〈 i 〉 p 〈 /i 〉 = 0.015) and severe pulmonary infections (3.7 vs. 1.1%; 〈 i 〉 p 〈 /i 〉 = 0.035) were more frequent with AAT. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 AAT and pirfenidone had outcomes comparable to those of pirfenidone alone in patients with IPF, underscoring the need for prospective trials to elucidate the role of AAT with or without antifibrotic drugs as a treatment for IPF.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000468546
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
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  • 5
    Online Resource
    Online Resource
    Statin Therapy and Outcomes in Trials of Nintedanib in Idiopathic Pulmonary Fibrosis
    S. Karger AG ; 2018
    In:  Respiration Vol. 95, No. 5 ( 2018), p. 317-326
    Details
    In: Respiration, S. Karger AG, Vol. 95, No. 5 ( 2018), p. 317-326
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Cardiovascular comorbidities are frequent in patients with idiopathic pulmonary fibrosis (IPF), and many patients with IPF receive treatment with statins to reduce cardiovascular risk. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 We investigated whether statin use at baseline was associated with differences in disease progression in placebo-treated patients or influenced the treatment effect of nintedanib in the INPULSIS® trials. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Post-hoc subgroup analyses of patients receiving versus not receiving statins at baseline using pooled data from the INPULSIS® trials. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 At baseline, 312 patients received statins and 749 did not. The annual rates of decline in forced vital capacity (FVC) in patients treated with nintedanib and placebo, respectively, were –78.9 and –187.6 mL/year in patients who received statins at baseline, and –127.9 and –237.9 mL/year in patients who did not. The effect of nintedanib was consistent across subgroups ( 〈 i 〉 p 〈 /i 〉 = 0.9590). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 In the INPULSIS® trials, there was a numerically lower FVC decline in placebo-treated patients with IPF who received statins at baseline versus those who did not. Use of statins at baseline did not influence the treatment effect of nintedanib. Prospective data are needed to assess the impact of statins on the course of IPF.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000486286
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1464419-8
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