Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in context
Summary: Background: Idiopathic pulmonary fibrosis (IPF) is a progressive, deadly lung disease with several factors, including respiratory tract infections (RTI), for disease worsening. There's no comprehensive data on RTI incidence in IPF patients across different therapies, including antifib...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537024005455 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832591762033475584 |
|---|---|
| author | Zsombor Matics Anna Bardóczi Csongor Galkó Bence Szabó Noémi Gede Zsolt Molnár Gábor Duray Caner Turan Péter Hegyi Gábor Horváth Veronika Müller |
| author_facet | Zsombor Matics Anna Bardóczi Csongor Galkó Bence Szabó Noémi Gede Zsolt Molnár Gábor Duray Caner Turan Péter Hegyi Gábor Horváth Veronika Müller |
| author_sort | Zsombor Matics |
| collection | DOAJ |
| description | Summary: Background: Idiopathic pulmonary fibrosis (IPF) is a progressive, deadly lung disease with several factors, including respiratory tract infections (RTI), for disease worsening. There's no comprehensive data on RTI incidence in IPF patients across different therapies, including antifibrotic (nintedanib or pirfenidone), investigative or placebo treatments. Methods: A systematic search of databases Medline, EMBASE, Cochrane Central, Web of Science and Scopus was conducted on September 30th 2024 (PROSPERO registration number: CRD42023484213). Only randomized controlled trials of drugs intended for IPF treatment in adults and reporting RTI incidence were included. Pooled risk ratio with 95% confidence interval (CI), risk of bias, GRADE and CINEMA assessments were conducted along with subgroup analyses for upper and lower RTI and for different antifibrotic doses. Findings: A total of 27 trials of different drugs aimed for IPF therapy were pooled in a pairwise meta-analysis, 11,542 patients were analyzed with an overall number of 4156 RTI events, representing an average incidence of 38.4 ± 23.5%. Most therapies did not affect RTI risk in IPF, although single trials with everolimus and trimethoprim/sulfamethoxazole showed a significant decrease compared to placebo. For antifibrotics, RTI incidence was similar with pirfenidone treatment compared to nintedanib (RR: 0.98 CI: [0.71; 1.36]) and compared to placebo (RR: 0.88 CI: [0.69; 1.10]) and nintedanib compared to placebo (RR: 0.89 CI: [0.71; 1.12]). Interpretation: RTIs are frequently reported adverse events in IPF patients over a one-year period, with different investigated treatments showing no profound impact compared to placebo. Future clinical trials should focus on targeting treatable traits like RTIs. Funding: None. |
| format | Article |
| id | doaj-art-41ad2bd716b8476d99e99e6760f9e116 |
| institution | Kabale University |
| issn | 2589-5370 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj-art-41ad2bd716b8476d99e99e6760f9e1162025-01-22T05:43:11ZengElsevierEClinicalMedicine2589-53702025-01-0179102966Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in contextZsombor Matics0Anna Bardóczi1Csongor Galkó2Bence Szabó3Noémi Gede4Zsolt Molnár5Gábor Duray6Caner Turan7Péter Hegyi8Gábor Horváth9Veronika Müller10Department of Pulmonology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Pulmonology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Pulmonology, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary; Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, PolandCentre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary; Heart and Vascular Center, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryDepartment of Pulmonology, Semmelweis University, Budapest, HungaryDepartment of Pulmonology, Semmelweis University, Budapest, Hungary; Corresponding author. Department of Pulmonology, Semmelweis University, Tomo utca 25-29, Budapest 1083, Hungary.Summary: Background: Idiopathic pulmonary fibrosis (IPF) is a progressive, deadly lung disease with several factors, including respiratory tract infections (RTI), for disease worsening. There's no comprehensive data on RTI incidence in IPF patients across different therapies, including antifibrotic (nintedanib or pirfenidone), investigative or placebo treatments. Methods: A systematic search of databases Medline, EMBASE, Cochrane Central, Web of Science and Scopus was conducted on September 30th 2024 (PROSPERO registration number: CRD42023484213). Only randomized controlled trials of drugs intended for IPF treatment in adults and reporting RTI incidence were included. Pooled risk ratio with 95% confidence interval (CI), risk of bias, GRADE and CINEMA assessments were conducted along with subgroup analyses for upper and lower RTI and for different antifibrotic doses. Findings: A total of 27 trials of different drugs aimed for IPF therapy were pooled in a pairwise meta-analysis, 11,542 patients were analyzed with an overall number of 4156 RTI events, representing an average incidence of 38.4 ± 23.5%. Most therapies did not affect RTI risk in IPF, although single trials with everolimus and trimethoprim/sulfamethoxazole showed a significant decrease compared to placebo. For antifibrotics, RTI incidence was similar with pirfenidone treatment compared to nintedanib (RR: 0.98 CI: [0.71; 1.36]) and compared to placebo (RR: 0.88 CI: [0.69; 1.10]) and nintedanib compared to placebo (RR: 0.89 CI: [0.71; 1.12]). Interpretation: RTIs are frequently reported adverse events in IPF patients over a one-year period, with different investigated treatments showing no profound impact compared to placebo. Future clinical trials should focus on targeting treatable traits like RTIs. Funding: None.http://www.sciencedirect.com/science/article/pii/S2589537024005455Idiopathic pulmonary fibrosisRespiratory tract infectionPirfenidon∗NintedanibSafetyMeta-analysis |
| spellingShingle | Zsombor Matics Anna Bardóczi Csongor Galkó Bence Szabó Noémi Gede Zsolt Molnár Gábor Duray Caner Turan Péter Hegyi Gábor Horváth Veronika Müller Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in context EClinicalMedicine Idiopathic pulmonary fibrosis Respiratory tract infection Pirfenidon∗ Nintedanib Safety Meta-analysis |
| title | Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in context |
| title_full | Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in context |
| title_fullStr | Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in context |
| title_full_unstemmed | Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in context |
| title_short | Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysisResearch in context |
| title_sort | treatable traits in idiopathic pulmonary fibrosis focus on respiratory tract infections a systematic review and a meta analysisresearch in context |
| topic | Idiopathic pulmonary fibrosis Respiratory tract infection Pirfenidon∗ Nintedanib Safety Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2589537024005455 |
| work_keys_str_mv | AT zsombormatics treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT annabardoczi treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT csongorgalko treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT benceszabo treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT noemigede treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT zsoltmolnar treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT gaborduray treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT canerturan treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT peterhegyi treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT gaborhorvath treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext AT veronikamuller treatabletraitsinidiopathicpulmonaryfibrosisfocusonrespiratorytractinfectionsasystematicreviewandametaanalysisresearchincontext |