Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory Agency, London, UK.
InterMune UK and Ireland (now part of Roche), Grove House 2nd Floor, 248A Marylebone Road, London, UK.
Adv Ther. 2018 May;35(5):724-736. doi: 10.1007/s12325-018-0693-1. Epub 2018 Apr 11.
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.
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.
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.
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.
InterMune UK and Ireland (now part of F. Hoffman La Roche).
最近在特发性肺纤维化患者治疗方面的进展有可能提高生存率。需要基于人群的疾病负担估计来评估新批准疗法的未来影响。本研究的目的是描述英国特发性肺纤维化患者的发病率、患病率和生存率。
在 2000 年至 2012 年间,使用来自临床实践研究数据链初级保健数据的患者队列(N=9748108)来确定特发性肺纤维化-临床综合征的新发和现患病例。对新发病例进行随访以确定死亡情况。使用泊松和 Cox 回归分别计算死亡率的发病率比(IRR)和风险比。根据年龄、性别和战略卫生当局进行调整。使用 Kaplan-Meier 分析估计从诊断到死亡的生存情况。
使用狭义和广义特发性肺纤维化-临床综合征定义,分别确定了 1491 例和 4527 例新发病例。在研究期间,发病率和患病率增加。与 2000 年相比,2012 年的发病率几乎增加了 80%[IRR 1.78(95%CI 1.50-2.11;广义定义)],尽管狭义定义的发病率有所下降[0.50(0.38-0.65)]。广义病例组(n=2168)和狭义病例组(n=996)的中位生存时间分别为 3.0 年(95%CI 2.8-3.1)和 2.7 年(95%CI 2.5-3.0)。未观察到生存率的显著变化。
自 2000 年以来,特发性肺纤维化的发病率有所增加,生存状况仍然较差。这些结果为衡量未来治疗变化的效果提供了基准。
InterMune UK and Ireland(现为 F. Hoffman La Roche 的一部分)。