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. 2018 May;35(5):724-736.
doi: 10.1007/s12325-018-0693-1. Epub 2018 Apr 11.

Incidence, Prevalence, and Survival of Patients with Idiopathic Pulmonary Fibrosis in the UK

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Incidence, Prevalence, and Survival of Patients with Idiopathic Pulmonary Fibrosis in the UK

Helen Strongman et al. Adv Ther. 2018 May.

Abstract

Introduction: Recent developments in the care of patients with idiopathic pulmonary fibrosis have the potential to improve survival rates. Population-based estimates of the current disease burden are needed to evaluate the future impact of newly approved therapies. The objective of this study is to describe incidence, prevalence, and survival of idiopathic pulmonary fibrosis patients in the UK.

Methods: Between 2000 and 2012, a patient cohort (N = 9,748,108), identified from Clinical Practice Research Datalink primary care data, was used to identify incident and prevalent cases of idiopathic pulmonary fibrosis-clinical syndrome. Incident cases were followed up to identify deaths. Poisson and Cox regressions were used to calculate incidence rate ratios (IRR) and hazard ratios for mortality, respectively. Adjustments were made for age, gender, and strategic health authority. Survival from diagnosis was estimated using Kaplan-Meier analysis.

Results: In total 1491 and 4527 incident cases were identified using narrow and broad idiopathic pulmonary fibrosis-clinical syndrome definitions, respectively. Incidence and prevalence increased during the study. Compared with 2000, a near 80% increase in incidence was observed by 2012 [IRR 1.78 (95% CI 1.50-2.11; broad definition)], despite an observed decrease using the narrow definition [0.50 (0.38-0.65)]. Median survival was 3.0 years (95% CI 2.8-3.1) and 2.7 years (95% CI 2.5-3.0) in broad (n = 2168) and narrow case sets (n = 996), respectively. No significant changes in survival were observed.

Conclusions: Idiopathic pulmonary fibrosis incidence rates have increased since 2000 and survival remains poor. These results provide a benchmark against which the effects of future treatment changes can be measured.

Funding: InterMune UK and Ireland (now part of F. Hoffman La Roche).

Keywords: CPRD GOLD; Idiopathic pulmonary fibrosis; Incidence; Population-based study; Prevalence; Respiratory; Survival.

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Figures

Fig. 1
Fig. 1
Adjusted incidence rate ratios of IPF–CS stratified by calendar year using a narrow definition and b broad definition. CPRD, Clinical Practice Research Datalink; IPF–CS, idiopathic pulmonary fibrosis clinical syndrome. All incidence rate ratios are mutually adjusted for other variables: gender, age group, and strategic health authority
Fig. 2
Fig. 2
Crude incidence rates of IPF–CS stratified by a calendar year, b gender, c age, and d strategic health authority. CPRD, Clinical Practice Research Datalink; IPF–CS, idiopathic pulmonary fibrosis clinical syndrome; Yorks, Yorkshire
Fig. 3
Fig. 3
Prevalence rates of IPF–CS stratified by a calendar year, b gender, c age, and d strategic health authority. CPRD, Clinical Practice Research Datalink; IPF–CS, idiopathic pulmonary fibrosis clinical syndrome; Yorks, Yorkshire. “[a]” For this analysis the lower age groups (0–39 and 40–44) and two regions (Yorkshire & The Humber and North East) have been combined in line with CPRD policy on low cell counts
Fig. 4
Fig. 4
Kaplan–Meier survival analysis for all incident cases of IPF–CS a using broad and narrow case definitions, b by year of diagnosis using the broad case definition

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