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他汀类药物治疗与尼达尼布治疗特发性肺纤维化临床试验结局。

Statin Therapy and Outcomes in Trials of Nintedanib in Idiopathic Pulmonary Fibrosis.

机构信息

Center for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Care Medicine, Thoraxklinik, University of Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany.

Ruhrlandklinik, University Hospital, University of Duisburg-Essen, Essen, Germany.

出版信息

Respiration. 2018;95(5):317-326. doi: 10.1159/000486286. Epub 2018 Feb 7.

Abstract

BACKGROUND

Cardiovascular comorbidities are frequent in patients with idiopathic pulmonary fibrosis (IPF), and many patients with IPF receive treatment with statins to reduce cardiovascular risk.

OBJECTIVES

We investigated whether statin use at baseline was associated with differences in disease progression in placebo-treated patients or influenced the treatment effect of nintedanib in the INPULSIS® trials.

METHODS

Post-hoc subgroup analyses of patients receiving versus not receiving statins at baseline using pooled data from the INPULSIS® trials.

RESULTS

At baseline, 312 patients received statins and 749 did not. The annual rates of decline in forced vital capacity (FVC) in patients treated with nintedanib and placebo, respectively, were -78.9 and -187.6 mL/year in patients who received statins at baseline, and -127.9 and -237.9 mL/year in patients who did not. The effect of nintedanib was consistent across subgroups (p = 0.9590).

CONCLUSIONS

In the INPULSIS® trials, there was a numerically lower FVC decline in placebo-treated patients with IPF who received statins at baseline versus those who did not. Use of statins at baseline did not influence the treatment effect of nintedanib. Prospective data are needed to assess the impact of statins on the course of IPF.

摘要

背景

特发性肺纤维化(IPF)患者常伴有心血管合并症,许多 IPF 患者接受他汀类药物治疗以降低心血管风险。

目的

我们旨在研究基线时使用他汀类药物是否与安慰剂治疗患者的疾病进展差异相关,或影响 INPULSIS®试验中尼达尼布的治疗效果。

方法

使用 INPULSIS®试验的汇总数据,对基线时接受他汀类药物与未接受他汀类药物治疗的患者进行事后亚组分析。

结果

基线时,312 例患者接受了他汀类药物治疗,749 例患者未接受。分别接受尼达尼布和安慰剂治疗的患者中,基线时接受他汀类药物治疗的患者的用力肺活量(FVC)年下降率分别为-78.9 和-187.6 mL/年,而未接受他汀类药物治疗的患者的 FVC 年下降率分别为-127.9 和-237.9 mL/年。尼达尼布的疗效在各亚组中一致(p = 0.9590)。

结论

在 INPULSIS®试验中,基线时接受他汀类药物治疗的 IPF 安慰剂治疗患者的 FVC 下降率较未接受他汀类药物治疗的患者低,但数值上有所降低。基线时使用他汀类药物并未影响尼达尼布的治疗效果。需要前瞻性数据来评估他汀类药物对 IPF 病程的影响。

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