Delay and inequalities in the treatment of idiopathic pulmonary fibrosis: the case of two Nordic countries
| العنوان: | Delay and inequalities in the treatment of idiopathic pulmonary fibrosis: the case of two Nordic countries |
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| المؤلفون: | Ida Pesonen, Marjukka Myllärniemi, Giovanni Ferrara, C. M. Skold, Riitta Kaarteenaho, Lisa Carlson, Nicola Murgia |
| المساهمون: | Department of Medicine, Clinicum, University of Helsinki, Keuhkosairauksien yksikkö, HUS Heart and Lung Center |
| المصدر: | Multidisciplinary Respiratory Medicine Multidisciplinary Respiratory Medicine, Vol 13, Iss 1, Pp 1-6 (2018) |
| بيانات النشر: | PAGEPress Publications, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, Vital capacity, SMOKING VARIABLES, REGRESSION EQUATIONS, IPF-REGISTRY, Nintedanib, medicine.medical_treatment, Idiopathic pulmonary fibrosis, Interstitial lung disease, Nintedanib, Pirfenidone, Access to healthcare, Idiopathic pulmonary fibrosis, Interstitial lung disease, Pirfenidone, NO, Pulmonary function testing, 03 medical and health sciences, FEV1/FVC ratio, chemistry.chemical_compound, LUNG-FUNCTION TESTS, 0302 clinical medicine, Internal medicine, medicine, Lung transplantation, 030212 general & internal medicine, lcsh:RC705-779, business.industry, OF-LIFE, lcsh:Diseases of the respiratory system, Access to healthcare, respiratory system, EFFICACY, medicine.disease, REFERENCE VALUES, 3. Good health, 030228 respiratory system, chemistry, SAFETY, 3121 General medicine, internal medicine and other clinical medicine, Cohort, business, Research Article, medicine.drug |
| الوصف: | Background: Idiopathic pulmonary fibrosis (IPF) is characterized by progressive loss of lung function with high mortality within the first 5 years from diagnosis. In 2011–2014, two drugs, pirfenidone and nintedanib, have been approved worldwide for prevention of IPF progression. National IPF-registries have been established in both Finland and Sweden. Our study explored potential differences in the care of IPF in these two countries. Methods: Patients included consecutively in the Finnish and Swedish IPF-registries from January 1, 2014 through December 31, 2016 were included in the study. Data on demographics and lung function at the time of inclusion were collected. Access to antifibrotic drugs and data on disease outcomes, mortality and the proportion of patients who underwent lung transplantation, was collected during a 3-year follow up. Results: One-hundred and fifty-two patients from the Finnish and 160 patients from the Swedish IPF-cohorts were included in the study. At inclusion, Finnish patients were significantly older than the Swedish patients (74.6 years vs 72.5 years, p = 0.017). The proportion of non-smokers was significantly higher in the Finnish cohort (41.7% vs 26.9%, p = 0.007). Forced vital capacity (FVC), % of predicted (78.2 vs 71.7 for Finnish and Swedish patients, respectively, p = 0.01) and diffusion capacity for carbon monoxide (DLCO), % of predicted (53.3 vs 48.2 for Finnish and Swedish patients, respectively, p = 0.002) were significantly higher in the Finnish cohort compared to the Swedish cohort at the time of inclusion. During the 3-year follow up period, 45 (29.6%) Finnish and 111 (69.4%) Swedish patients, respectively, were initiated on treatment with an antifibrotic drug (pirfenidone or nintedanib) (p < 0.001). When comparing possible determinants of treatment, patients with higher FVC % were less likely to start antifibrotic drugs (OR 0.96, 95%CI 0.93–1.00, p < 0.024). To be resident in Sweden was the main determinant for receiving antifibrotic drugs (OR 5.48, 95%CI 2.65–11.33, p < 0.0001). No significant difference in number of deaths and lung transplantation during the follow up period was found. Conclusions: This study highlights differences concerning how IPF patients are treated in Finland and Sweden. How these differences will influence the long-term outcome of these patients is unknown. |
| وصف الملف: | application/pdf |
| تدمد: | 2049-6958 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::27ad322570157b941b69fbfe26eb7bea https://doi.org/10.1186/s40248-018-0126-7 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....27ad322570157b941b69fbfe26eb7bea |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 20496958 |
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