Acute exacerbation of chronic fibrosing interstitial pneumonia in patients receiving antifibrotic agents: incidence and risk factors from real-world experience

Table 3 Unadjusted and adjusted risk factors of acute exacerbation

		Hazard ratio	95%CI		p-value
Age		0.97	0.92	1.03	0.34
Age	< 65	ref
	≥65	0.65	0.27	1.60	0.35
Sex	Female	ref
	male	2.74	0.63	11.8	0.18
smoking	Yes	0.76	0.30	1.91	0.56
Clinical Diagnosis	IPF	Ref
	others	0.83	0.3	2.28	0.71
SLB, yes	yes	2.11	0.88	5.08	0.10
Commodity Index		0.82	0.44	1.50	0.52
TTE RVSP 40 mmHg	≥40 mmHg	2.51	1.05	6.05	0.04
FVC % predicted		0.97	0.95	0.99	0.026
FVC % predictive < 70%	Yes	2.53	1.0	6.3	0.049
DLCO % predicted		0.95	0.92	0.98	0.002
DLCO % predicted < 55%	Yes	2.3	0.92	5.8	0.08
GAP score		1.55	1.18	2.05	0.002
ILD-GAP score	0–3 points	ref
	4–5 points	1.44	0.51	4.08	0.50
	6–8 points	9.52	3.10	29.2	< 0.001
LTOT	No	ref
	introduced at same time	2.01	0.73	5.55	0.18
	prior to antifibrotic agent	4.79	1.56	14.7	0.006
KL6		1	0.99	1	0.91
KL6 High	> 1300	1.54	0.63	3.78	0.35
LDH		1.001	0.999	1.002	0.19
LDH High	> 239	1.33	0.55	3.20	0.53
Medication
H2 blocker use		0.70	0.16	3.04	0.63
PPI use		4.53	1.05	19.54	0.04
Corticosteroids		6.28	2.41	16.4	0.0002
anticoagulant	Yes	0.74	0.17	3.24	0.70
First-line antifibrotic agent	Nintedanib	Ref
	Pirfenidone	0.98	0.40	2.39	0.96
Time from diagnosis to antifibrotic agents (per month)		1.01	1.004	1.029	0.008
Multivariate analysis		aHR	95%CI		P-value
H2 blocker use	Yes	0.44	0.099	1.92	0.27
PPI use	Yes	5.05	1.17	21.9	0.03
Corticosteroids	Yes	11.4	4.07	32.01	< 0.001
Anticoagulant	Yes	0.79	0.18	3.46	0.75
First-line antifibrotic agents	Nintedanib	Ref
	Pirfenidone	1.26	0.50	3.20	0.62

AE acute exacerbation, IPF idiopathic pulmonary fibrosis, SLB surgical lung biopsy, TTE transthoracic echocardiogram, RVSP right ventricular systolic pressure, FVC forced vital capacity, DLCO carbon monoxide diffusing capacity of the lungs, ILD-GAP interstitial lung disease subtype, gender, age, and two lung physiology variables, LTOT Long-term oxygen therapy, PPI proton pump inhibitor, LDH lactate dehydrogenase

ISSN: 1471-2466