Dynamics of diagnoses and pharmacotherapy before and after diagnosing idiopathic pulmonary fibrosis

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Abstract

Background: Idiopathic pulmonary fibrosis (IPF) is a rare interstitial lung disease (ILD). The IPF diagnosis is typically delayed due to non-specific symptoms, but also due to treatment attempts on false indication or treatment targeted common comorbidities. This study aimed to assess the dynamics in the medication and diagnosis patterns in the period prior to and following an IPF diagnosis.

Methods: We identified all Danish patients with IPF in the period 2002 to 2017. We evaluated new and ongoing drug treatments and incident diagnoses in the 3 years prior to and 12 months after an IPF diagnosis by use of Danish nationwide registries. For each IPF case, ten random controls were recruited.

Results: A total of 650 IPF patients were identified (median age 73 years [IQR 65-78], 70.3% males). Prior to the IPF diagnosis, the most prevalent diagnoses were dyspnea, pneumonia and non-IPF ILDs. For drug use, IPF patients had a higher initiation rate for antibiotics, glucocorticoids 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 six months preceding their IPF diagnosis, when 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 for diagnoses with symptoms overlapping those of IPF was observed, particularly in a six months period prior to an IPF diagnosis. This emphasizes the need for an increased awareness of this disease, especially in patients with insufficient effect of otherwise initiated treatment.
Original languageEnglish
Article number1803
JournalEuropean Respiratory Journal
Volume56
Issue numberSuppl. 64
ISSN0903-1936
DOIs
Publication statusPublished - 2020
EventERS International Congress 2020 - Virtuel
Duration: 6. Sep 20209. Sep 2020

Conference

ConferenceERS International Congress 2020
LocationVirtuel
Period06/09/202009/09/2020

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