» Articles » PMID: 36753211

Antifibrotic Therapy in Idiopathic Pulmonary Fibrosis Candidates for Lung Transplantation Undergoing Pulmonary Rehabilitation

Abstract

Objective: To investigate the impact of pulmonary rehabilitation (PR) on functional outcomes and health-related quality of life (HRQoL) in idiopathic pulmonary fibrosis (IPF) patients placed on a lung transplant waitlist and receiving antifibrotic therapy (AFT).

Methods: This was a retrospective observational study of consecutive IPF patients receiving AFT with either pirfenidone or nintedanib (the AFT group) and undergoing PR between January of 2018 and March of 2020. The AFT group and the control group (i.e., IPF patients not receiving AFT) participated in a 12-week PR program consisting of 36 sessions. After having completed the program, the study participants were evaluated for the six-minute walk distance (6MWD) and HRQoL. Pre- and post-PR 6MWD and HRQoL were compared within groups and between groups.

Results: There was no significant difference between the AFT and control groups regarding baseline characteristics, including age, airflow limitation, comorbidities, and oxygen requirement. The AFT group had a significant increase in the 6MWD after 12 weeks of PR (effect size, 0.77; p < 0.05), this increase being significant in the between-group comparison as well (effect size, 0.55; p < 0.05). The AFT group showed a significant improvement in the physical component of HRQoL at 12 weeks (effect size, 0.30; p < 0.05).

Conclusions: Among IPF patients undergoing PR, those receiving AFT appear to have greater improvements in the 6MWD and the physical component of HRQoL than do those not receiving AFT.

References
1.
Caminati A, Lonati C, Cassandro R, Elia D, Pelosi G, Torre O . Comorbidities in idiopathic pulmonary fibrosis: an underestimated issue. Eur Respir Rev. 2019; 28(153). PMC: 9488913. DOI: 10.1183/16000617.0044-2019. View

2.
Graney B, Lee J . Impact of novel antifibrotic therapy on patient outcomes in idiopathic pulmonary fibrosis: patient selection and perspectives. Patient Relat Outcome Meas. 2018; 9:321-328. PMC: 6163010. DOI: 10.2147/PROM.S144425. View

3.
Chambers D, Cherikh W, Harhay M, Hayes Jr D, Hsich E, Khush K . The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult lung and heart-lung transplantation Report-2019; Focus theme: Donor and recipient size match. J Heart Lung Transplant. 2019; 38(10):1042-1055. PMC: 6816340. DOI: 10.1016/j.healun.2019.08.001. View

4.
Pereira C, Baddini-Martinez J, Baldi B, Jezler S, Rubin A, Alves R . Safety and tolerability of nintedanib in patients with idiopathic pulmonary fibrosis in Brazil. J Bras Pneumol. 2019; 45(5):e20180414. PMC: 8653976. DOI: 10.1590/1806-3713/e20180414. View

5.
. Erratum: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline: Treatment of Idiopathic Pulmonary Fibrosis. An Update of the 2011 Clinical Practice Guideline. Am J Respir Crit Care Med. 2015; 192(5):644. DOI: 10.1164/rccm.1925erratum. View