Pneumologie 2018; 72(S 01): S28-S29
DOI: 10.1055/s-0037-1619192
Sektion 7 – Klinische Pneumologie
Posterbegehung – Titel: Interstitielle und granulomatöse Lungenerkrankungen I, Lungentransplantation
Georg Thieme Verlag KG Stuttgart · New York

Quality of life trajectory in patients with idiopathic pulmonary fibrosis (IPF): longitudinal QoL assessment of the INSIGHTS-IPF registry

Authors

  • M Kreuter

    1   Zentrum für Interstitielle und Seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik; Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (TLRC); Mitglied des Deutschen Zentrums für Lungenforschung (DZL)

  • J Swigris

    2   Interstitial Lung Disease Program, National Jewish Health, Denver, Colorado, USA

  • D Pittrow

    3   Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden

  • S Geier

    4   Department Market Access, Boehringer Ingelheim

  • J Klotsche

    5   Epidemiologie, Deutsches Rheuma-Forschungsinstitut, Berlin

  • A Prasse

    6   Klinik für Pneumologie, Medizinische Hochschule, Hannover

  • H Wirtz

    7   Pneumologie, Universitätsklinikum der Universität Leipzig

  • D Koschel

    8   Zentrum für Pneumologie-, Thorax- und Gefäßchirurgie, Fachkrankenhaus Coswig

  • S Andreas

    9   Kardiologie und Pneumologie, Lungenfachklinik Immenhausen und Universitätsmedizin Göttingen

  • C Grohe

    10   Klinik für Pneumologie, ELK, Berlin Buch

  • H Wilkens

    11   Pneumologie, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg

  • L Hagmeyer

    12   Krankenhaus Bethanien, Solingen

  • D Skowasch

    13   Medical Clinic II, University Hospital Bonn

  • FJ Meyer

    14   Lungenzentrum München, LZM Bogenhausen-Harlaching, Städtisches Klinikum München GmbH

  • J Kirschner

    15   Center for Internal Medical Studies Cims, Bamberg

  • S Gläser

    16   Klinik und Poliklinik für Innere Medizin B, Forschungsbereich Pneumologie und Pneumologische Epidemiologie, Universitätsmedizin Greifswald; Klinik für Innere Medizin – Pneumologie, Greifswald and Vivantes Klinikum Spandau/Berlin

  • FJF Herth

    17   Zentrum für Interstitielle und Seltene Lungenerkrankungen, Thoraxklinik, Uniklinikum Heidelberg

  • T Welte

    18   Klinik für Pneumologie, Medizinische Hochschule Hannover

  • C Neurohr

    19   Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München

  • M Schweiblmair

    20   I. Medizinische Klinik, Klinikum Augsburg

  • M Held

    21   Abteilung Innere Medizin, Pneumologie, Standort Missioklinik, Klinikum Würzburg Mitte

  • T Bahmer

    22   Lungenclinic Großhansdorf

  • M Frankenberger

    19   Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München

  • J Behr

    23   Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München and Asklepios Fachkliniken München-Gauting; Member of the German Center for Lung Research (DZL)
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
21. Februar 2018 (online)

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    Rationale:

    Quality of life (QoL) is profoundly impaired in IPF patients; however, little is known about how their QoL changes over time. We analysed longitudinal data, gathered under real-world conditions, to improve understanding of the trajectory of QoL and its relationship to other variables in IPF patients.

    Methods:

    Data from 359 patients enrolled in an observational registry were included (77% male; mean values: age 68.5 ± 8.9 years, FVC% 68.1 ± 17.9, DLCO% 36.7 ± 16.8. QoL was assessed by questionnaires including the St. George's Respiratory Questionnaire (SGRQ) at enrollment and yearly thereafter. Mixed Models were used for the analyses of QoL in follow-up.

    Results:

    Mean follow up was 16.0 ± 9.1 months. The SGRQ significantly worsened, i.e. increased during follow-up (increase of 2.7 per year (95%CI: 1.4 – 4.0). An absolute decline in FVC% predicted ≥10% was associated with a significant deterioration in SGRQ by 13.7 (SD = 13.6), while patients with stable or improved FVC had a relevant improvement in SGRQ (mean =-5.4). Patients with a decrease of DLCO≥15% or of 6MWD≥50 m had a significant increase (i.e. deterioration) in SGRQ by 15.7 (SD = 14.5) and 8.9 (SD = 14.8) in follow-up, respectively. In multivariate analysis by a mixed model, predictors of a QoL worsening were older age, lower FVC, lower DLCO, high number of comorbid diseases and longer disease duration. Patients who died had a significant greater increase in SGRQ (mean 11.2 SD = 15) before death compared to patients who survived (mean 3.1, SD = 14.2). A similar pattern could be seen for mortality due to exacerbations (increase by 9.2 versus 4.5 for patients with and without exacerbations). If the physician judged the clinical course of IPF as a rapid progression, the patients SQRQ increased significantly in follow-up in mean by 15.1 (SD = 14.2). In contrast, patients with a judgement of stable disease reported a significantly smaller increase, i.e. less deterioration of SGRQ during follow-up (mean = 9.0, SD = 12.2).

    Conclusions:

    QoL assessement in the INSIGHTS-IPF registry demonstrates a close relationship between QoL and changes of pulmonary physiology, numbers of comorbidities, disease duration and clinical course of IPF including mortality.