open access

Vol 88, No 5 (2020)
Research paper
Published online: 2020-10-24
Submitted: 2020-02-13
Accepted: 2020-05-24
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The Gender–Age–Physiology system as a prognostic model in patients with idiopathic pulmonary fibrosis treated with nintedanib: a longitudinal cohort study

Mitsuhiro Abe, Kenji Tsushima, Keiichiro Yoshioka, Masashi Sakayori, Kenichi Suzuki, Yasutaka Hirasawa, Takeshi Kawasaki, Jun Ikari, Jiro Terada, Koichiro Tatsumi
DOI: 10.5603/ARM.a2020.0137
·
Pubmed: 33169806
·
Adv Respir Med 2020;88(5):369-376.

open access

Vol 88, No 5 (2020)
ORIGINAL PAPERS
Published online: 2020-10-24
Submitted: 2020-02-13
Accepted: 2020-05-24

Abstract

Introduction: The Gender-Age-Physiology (GAP) system is a tool for predicting prognosis in patients with idiopathic pulmonary fibrosis (IPF). Yet, to date, the GAP system has not been evaluated in patients with IPF who received nintedanib.
Material and methods: This single-center retrospective study included 89 patients with IPF who received Nintedanib for at least 3 months. All-cause mortality was set as the end point. Clinical parameters, including the GAP stage, were statistically analyzed for risk factors leading to mortality using the Cox proportional hazard model.
Results: The median follow-up was 16.4 months (range 3.7–37.4 months), during which 23 patients died. Univariate analysis revealed that the GAP stage (hazard ratio [HR] 3.00, 95% confidence interval [CI] 1.52–5.92, p = 0.0014) and PaO2 (HR 0.95, 95% CI 0.92–0.98, p = 0.0063) were significant prognostic factors. Multivariate analysis revealed that the GAP stage was a significant prognostic factor (HR 2.26, 95% CI 1.07–4.78, p = 0.031). Log-rank analysis revealed that there were no significant differences in “Gender” (p = 0.47) and “Age” (p = 0.18) factors. However, there were significant differences in “Physiology” factors (% of forced vital capacity, p = 0.018; % of diffusing capacity of lung carbon monoxide, p < 0.001). The cumulative incidences of mortality at 1 and 2 years were as follows: GAP I: 5.1% and 6.8%; GAP II: 9.5% and 29.3%; and GAP III: 18.9% and 84.2%.
Conclusions: The GAP system is useful as a prognostic tool in patients with IPF who have been treated with nintedanib.

Abstract

Introduction: The Gender-Age-Physiology (GAP) system is a tool for predicting prognosis in patients with idiopathic pulmonary fibrosis (IPF). Yet, to date, the GAP system has not been evaluated in patients with IPF who received nintedanib.
Material and methods: This single-center retrospective study included 89 patients with IPF who received Nintedanib for at least 3 months. All-cause mortality was set as the end point. Clinical parameters, including the GAP stage, were statistically analyzed for risk factors leading to mortality using the Cox proportional hazard model.
Results: The median follow-up was 16.4 months (range 3.7–37.4 months), during which 23 patients died. Univariate analysis revealed that the GAP stage (hazard ratio [HR] 3.00, 95% confidence interval [CI] 1.52–5.92, p = 0.0014) and PaO2 (HR 0.95, 95% CI 0.92–0.98, p = 0.0063) were significant prognostic factors. Multivariate analysis revealed that the GAP stage was a significant prognostic factor (HR 2.26, 95% CI 1.07–4.78, p = 0.031). Log-rank analysis revealed that there were no significant differences in “Gender” (p = 0.47) and “Age” (p = 0.18) factors. However, there were significant differences in “Physiology” factors (% of forced vital capacity, p = 0.018; % of diffusing capacity of lung carbon monoxide, p < 0.001). The cumulative incidences of mortality at 1 and 2 years were as follows: GAP I: 5.1% and 6.8%; GAP II: 9.5% and 29.3%; and GAP III: 18.9% and 84.2%.
Conclusions: The GAP system is useful as a prognostic tool in patients with IPF who have been treated with nintedanib.

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Keywords

diffusing capacity of lung carbon monoxide; forced vital capacity; GAP stage; idiopathic pulmonary fibrosis; nintedanib

About this article
Title

The Gender–Age–Physiology system as a prognostic model in patients with idiopathic pulmonary fibrosis treated with nintedanib: a longitudinal cohort study

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 5 (2020)

Article type

Research paper

Pages

369-376

Published online

2020-10-24

DOI

10.5603/ARM.a2020.0137

Pubmed

33169806

Bibliographic record

Adv Respir Med 2020;88(5):369-376.

Keywords

diffusing capacity of lung carbon monoxide
forced vital capacity
GAP stage
idiopathic pulmonary fibrosis
nintedanib

Authors

Mitsuhiro Abe
Kenji Tsushima
Keiichiro Yoshioka
Masashi Sakayori
Kenichi Suzuki
Yasutaka Hirasawa
Takeshi Kawasaki
Jun Ikari
Jiro Terada
Koichiro Tatsumi

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