Phosphodiesterase 5 inhibitor treatment and survival in interstitial lung disease pulmonary hypertension: A Bayesian retrospective observational cohort studyстатья из журнала
Аннотация: Abstract Background and Objective Pulmonary hypertension is a life‐limiting complication of interstitial lung disease (ILD‐PH). We investigated whether treatment with phosphodiesterase 5 inhibitors (PDE5i) in patients with ILD‐PH was associated with improved survival. Methods Consecutive incident patients with ILD‐PH and right heart catheterisation, echocardiography and spirometry data were followed from diagnosis to death, transplantation or censoring with all follow‐up and survival data modelled by Bayesian methods. Results The diagnoses in 128 patients were idiopathic pulmonary fibrosis ( n = 74, 58%), hypersensitivity pneumonitis ( n = 17, 13%), non‐specific interstitial pneumonia ( n = 12, 9%), undifferentiated ILD ( n = 8, 6%) and other lung diseases ( n = 17, 13%). Final outcomes were death ( n = 106, 83%), transplantation ( n = 9, 7%) and censoring ( n = 13, 10%). Patients treated with PDE5i ( n = 50, 39%) had higher mean pulmonary artery pressure (median 38 mm Hg [interquartile range, IQR: 34, 43] vs. 35 mm Hg [IQR: 31, 38], p = 0.07) and percentage predicted forced vital capacity (FVC; median 57% [IQR: 51, 73] vs. 52% [IQR: 45, 66], p= 0.08) though differences did not reach significance. Patients treated with PDE5i survived longer than untreated patients (median 2.18 years [95% CI: 1.43, 3.04] vs. 0.94 years [0.69, 1.51], p = 0.003) independent of all other prognostic markers by Bayesian joint‐modelling (HR 0.39, 95% CI: 0.23, 0.59, p < 0.001) and propensity‐matched analyses (HR 0.38, 95% CI: 0.22, 0.58, p < 0.001). Survival difference with treatment was significantly larger if right ventricular function was normal, rather than abnormal, at presentation (+2.55 years, 95% CI: −0.03, +3.97 vs. +0.98 years, 95% CI: +0.47, +2.00, p = 0.04). Conclusion PDE5i treatment in ILD‐PH should be investigated by a prospective randomized trial.
Год издания: 2022
Авторы: Timothy J. W. Dawes, Colm McCabe, Konstantinos Dimopoulos, Iain Stewart, Simon Bax, Carl Harries, Chinthaka B. Samaranayake, Aleksander Kempny, Philip L. Molyneaux, Samuel Seitler, Thomas Semple, Wei Li, Peter M. George, Vasileios Kouranos, Felix Chua, Elisabetta Renzoni, Maria Kokosi, Gisli Jenkins, Athol U. Wells, Stephen J. Wort, Laura Price
Издательство: Wiley
Источник: Respirology
Ключевые слова: Pulmonary Hypertension Research and Treatments, Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis, Vascular Anomalies and Treatments
Другие ссылки: Respirology (HTML)
Spiral (Imperial College London) (PDF)
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PubMed (HTML)
Spiral (Imperial College London) (PDF)
Spiral (Imperial College London) (HTML)
PubMed (HTML)
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Том: 28
Выпуск: 3
Страницы: 262–272