Journal article
Anti-fibrotic therapy and lung transplant outcomes in patients with idiopathic pulmonary fibrosis
Therapeutic advances in respiratory disease, Vol.17, pp.1-10
01/2023
DOI: 10.1177/17534666231165912
PMCID: PMC10126649
PMID: 37073794
Abstract
It is unclear whether continuing anti-fibrotic therapy until the time of lung transplant increases the risk of complications in patients with idiopathic pulmonary fibrosis.
To investigate whether the time between discontinuation of anti-fibrotic therapy and lung transplant in patients with idiopathic pulmonary fibrosis affects the risk of complications.
We assessed intra-operative and post-transplant complications among patients with idiopathic pulmonary fibrosis who underwent lung transplant and had been treated with nintedanib or pirfenidone continuously for ⩾ 90 days at listing. Patients were grouped according to whether they had a shorter (⩽ 5 medication half-lives) or longer (> 5 medication half-lives) time between discontinuation of anti-fibrotic medication and transplant. Five half-lives corresponded to 2 days for nintedanib and 1 day for pirfenidone.
Among patients taking nintedanib (
= 107) or pirfenidone (
= 190), 211 (71.0%) had discontinued anti-fibrotic therapy ⩽ 5 medication half-lives before transplant. Anastomotic and sternal dehiscence occurred only in this group (anastomotic: 11 patients [5.2%],
= 0.031 vs patients with longer time between discontinuation of anti-fibrotic medication and transplant; sternal: 12 patients [5.7%],
= 0.024). No differences were observed in surgical wound dehiscence, length of hospital stay, or survival to discharge between groups with a shorter versus longer time between discontinuation of anti-fibrotic therapy and transplant.
Anastomotic and sternal dehiscence only occurred in patients with idiopathic pulmonary fibrosis who discontinued anti-fibrotic therapy < 5 medication half-lives before transplant. The frequency of other intra-operative and post-transplant complications did not appear to differ depending on when anti-fibrotic therapy was discontinued.
clinicaltrials.gov NCT04316780: https://clinicaltrials.gov/ct2/show/NCT04316780.
Details
- Title: Subtitle
- Anti-fibrotic therapy and lung transplant outcomes in patients with idiopathic pulmonary fibrosis
- Creators
- Todd L Astor - Massachusetts General HospitalHilary J Goldberg - Brigham and Women's HospitalLaurie D Snyder - Duke UniversityAndrew Courtwright - University of PennsylvaniaRamsey Hachem - Washington University in St. LouisTahuanty Pena - University of IowaLorenzo Zaffiri - Duke UniversityGerard J Criner - Temple UniversityMarie M Budev - Cleveland ClinicTany Thaniyavarn - Brigham and Women's HospitalThomas B Leonard - Boehringer Ingelheim (United States)Shaun Bender - Boehringer Ingelheim (United States)Aliaa Barakat - ILD (Czechia)Janis L Breeze - Tufts Medical CenterPeter LaCamera - St. Elizabeth's Medical Center
- Resource Type
- Journal article
- Publication Details
- Therapeutic advances in respiratory disease, Vol.17, pp.1-10
- DOI
- 10.1177/17534666231165912
- PMID
- 37073794
- PMCID
- PMC10126649
- NLM abbreviation
- Ther Adv Respir Dis
- ISSN
- 1753-4666
- eISSN
- 1753-4666
- Grant note
- name: This study was funded by Boehringer Ingelheim Pharmaceuticals, Inc (BIPI).
- Language
- English
- Date published
- 01/2023
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984398210102771
Metrics
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