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Prognosis and Survival in Idiopathic Pulmonary Fibrosis in the Era of Antifibrotic Therapy in Italy: Evidence from a Longitudinal Population Study Based on Healthcare Utilization Databases

Author

Listed:
  • Marica Iommi

    (Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy)

  • Andrea Faragalli

    (Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy)

  • Martina Bonifazi

    (Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
    Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, 60166 Ancona, Italy)

  • Federico Mei

    (Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
    Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, 60166 Ancona, Italy)

  • Lara Letizia Latini

    (Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
    Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, 60166 Ancona, Italy)

  • Marco Pompili

    (Regional Health Agency of Marche, 60121 Ancona, Italy)

  • Flavia Carle

    (Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
    National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milano, Italy)

  • Rosaria Gesuita

    (Center of Epidemiology Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
    National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milano, Italy)

Abstract

The aim was to evaluate the determinants of acute exacerbation (AE) and death in new cases of idiopathic pulmonary fibrosis (IPF) using administrative databases in the Marche Region. Adults at their first prescription of antifibrotics or hospitalization with a diagnosis of IPF occurring in 2014–2019 were considered as new cases. Multiple Cox regression was used to estimate the risk of AE and of all-cause mortality adjusted by demographic and clinical characteristics, stratifying patients according to antifibrotic treatment. Overall, 676 new cases of IPF were identified and 276 deaths and 248 AE events occurred. In never-treated patients, the risk of AE was higher in patients with poor health conditions at diagnosis; the risk of death was higher in males, in patients aged ≥75 and in those with poor health conditions at baseline. The increasing number of AEs increased the risk of death in treated and never-treated patients. Within the limits of an observational study based on secondary data, the combined use of healthcare administrative databases allows the accurate analysis of progression and survival of IPF from the beginning of the antifibrotic therapy era, suggesting that timely and early diagnosis is critical to prescribing the most suitable treatment to increase survival and maintain a healthy life expectancy.

Suggested Citation

  • Marica Iommi & Andrea Faragalli & Martina Bonifazi & Federico Mei & Lara Letizia Latini & Marco Pompili & Flavia Carle & Rosaria Gesuita, 2022. "Prognosis and Survival in Idiopathic Pulmonary Fibrosis in the Era of Antifibrotic Therapy in Italy: Evidence from a Longitudinal Population Study Based on Healthcare Utilization Databases," IJERPH, MDPI, vol. 19(24), pages 1-10, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:24:p:16689-:d:1000991
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    References listed on IDEAS

    as
    1. Marica Iommi & Martina Bonifazi & Andrea Faragalli & Lara Letizia Latini & Federico Mei & Liana Spazzafumo & Edlira Skrami & Luigi Ferrante & Flavia Carle & Rosaria Gesuita, 2022. "Occurrence of Idiopathic Pulmonary Fibrosis in Italy: Latest Evidence from Real-World Data," IJERPH, MDPI, vol. 19(5), pages 1-10, February.
    2. Debashis Ghosh & D. Y. Lin, 2000. "Nonparametric Analysis of Recurrent Events and Death," Biometrics, The International Biometric Society, vol. 56(2), pages 554-562, June.
    3. Edlira Skrami & Flavia Carle & Simona Villani & Paola Borrelli & Antonella Zambon & Giovanni Corrao & Paolo Trerotoli & Vincenzo Guardabasso & Rosaria Gesuita, 2019. "Availability of Real-World Data in Italy: A Tool to Navigate Regional Healthcare Utilization Databases," IJERPH, MDPI, vol. 17(1), pages 1-12, December.
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