PMID- 37245284
OWN - NLM
STAT- MEDLINE
DCOM- 20230619
LR  - 20230619
IS  - 2212-5353 (Electronic)
IS  - 2212-5345 (Linking)
VI  - 61
IP  - 4
DP  - 2023 Jul
TI  - Elderly idiopathic pulmonary fibrosis patients remain on therapy despite higher 
      incidence of adverse events and dose reductions.
PG  - 490-497
LID - S2212-5345(23)00047-3 [pii]
LID - 10.1016/j.resinv.2023.04.007 [doi]
AB  - BACKGROUND: Idiopathic pulmonary fibrosis (IPF) predominantly affects people over 
      the age of 60 years and its incidence increases with age. Limited data is 
      available on the use of antifibrotics in the elderly IPF population. We aimed to 
      examine the tolerability and safety of antifibrotics (pirfenidone, nintedanib) in 
      elderly patients with IPF in a real-world setting. METHODS: Medical records of 
      284 elderly (>/=75 years) and 446 non-elderly IPF patients (<75 years) were 
      retrospectively analyzed in this multi-center study. Patient characteristics, 
      treatments, adverse events (AEs), tolerability, hospitalizations, exacerbations, 
      and mortality were compared between the elderly and non-elderly group. RESULTS: 
      In the elderly group, the mean age was 79 years and the mean antifibrotic 
      treatment duration was 26.1 months. The most commonly reported AEs were weight 
      loss, loss of appetite and nausea. Elderly IPF patients had a significantly 
      higher incidence of AEs (62.9% vs. 55.1%, p = 0.039) and dose reductions (27.4% 
      vs. 18.1%, p = 0.003) than the non-elderly did, but the rate of discontinuation 
      of antifibrotics was not different between groups (13% vs. 10.8%, p = 0.352). In 
      addition, the severity of the disease, frequency of hospitalizations, 
      exacerbations, and mortality rates were higher in elderly patients. CONCLUSION: 
      The present study showed that elderly IPF patients experienced significantly 
      increased AEs and dose reductions due to antifibrotic use, while the 
      discontinuation rates of the drugs were similar to those of drugs used by 
      non-elderly patients.
CI  - Copyright (c) 2023 The Japanese Respiratory Society. Published by Elsevier B.V. All 
      rights reserved.
FAU - Cilli, Aykut
AU  - Cilli A
AD  - Department of Respiratory Disease, Akdeniz University, Antalya, Turkey. 
      Electronic address: acilli@akdeniz.edu.tr.
FAU - Ocal, Nesrin
AU  - Ocal N
AD  - Department of Respiratory Diseases, University of Health Sciences, Gulhane 
      Faculty of Medicine, Ankara, Turkey.
FAU - Uzer, Fatih
AU  - Uzer F
AD  - Department of Respiratory Disease, Akdeniz University, Antalya, Turkey.
FAU - Coskun, Funda
AU  - Coskun F
AD  - Department of Respiratory Disease, Uludag University, Bursa, Turkey.
FAU - Sevinc, Can
AU  - Sevinc C
AD  - Department of Respiratory Disease, Dokuz Eylul University, Izmir, Turkey.
FAU - Ursavas, Ahmet
AU  - Ursavas A
AD  - Department of Respiratory Disease, Uludag University, Bursa, Turkey.
FAU - Yildiz, Pinar
AU  - Yildiz P
AD  - Department of Respiratory Disease, SBU Yedikule Training and Research Hospital, 
      Istanbul, Turkey.
FAU - Deniz, Pelin Pinar
AU  - Deniz PP
AD  - Department of Respiratory Disease, Cukurova University, Adana, Turkey.
FAU - Yilmaz Demirci, Nilgun
AU  - Yilmaz Demirci N
AD  - Department of Respiratory Disease, Gazi University, Ankara, Turkey.
FAU - Ozbey, Gamze
AU  - Ozbey G
AD  - Department of Respiratory Disease, Akdeniz University, Antalya, Turkey.
FAU - Yurttas, Ahmet
AU  - Yurttas A
AD  - Department of Respiratory Disease, Uludag University, Bursa, Turkey.
FAU - Hanta, Ismail
AU  - Hanta I
AD  - Department of Respiratory Disease, Cukurova University, Adana, Turkey.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230526
PL  - Netherlands
TA  - Respir Investig
JT  - Respiratory investigation
JID - 101581124
RN  - 0 (Pyridones)
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Retrospective Studies
MH  - *Drug Tapering
MH  - Incidence
MH  - Treatment Outcome
MH  - *Idiopathic Pulmonary Fibrosis/drug therapy/epidemiology/chemically induced
MH  - Pyridones/therapeutic use
OTO - NOTNLM
OT  - Idiopathic pulmonary fibrosis
OT  - Nintedanib
OT  - Pirfenidone
OT  - Safety
OT  - Tolerability
COIS- Conflict of Interest None.
EDAT- 2023/05/28 19:11
MHDA- 2023/06/19 13:09
CRDT- 2023/05/28 18:01
PHST- 2023/01/26 00:00 [received]
PHST- 2023/03/14 00:00 [revised]
PHST- 2023/04/10 00:00 [accepted]
PHST- 2023/06/19 13:09 [medline]
PHST- 2023/05/28 19:11 [pubmed]
PHST- 2023/05/28 18:01 [entrez]
AID - S2212-5345(23)00047-3 [pii]
AID - 10.1016/j.resinv.2023.04.007 [doi]
PST - ppublish
SO  - Respir Investig. 2023 Jul;61(4):490-497. doi: 10.1016/j.resinv.2023.04.007. Epub 
      2023 May 26.