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No improved outcomes seen for IPF patients in antacid therapy

Patients in this study with idiopathic pulmonary fibrosis who received antacid therapy did not show clinically significant improvements compared with patients in a control group, according to recent research.

“In this post-hoc analysis of patients with idiopathic pulmonary fibrosis (IPF) randomly assigned to placebo in three large controlled trials, antacid therapy did not yield clinically significant improvements in outcomes after 52 weeks,” Michael Kreuter, MD, from the Center for Interstitial and Rare Lung Diseases and Pneumology and Respiratory Critical Care Medicine at Thoraxklinik, University of Heidelberg in Germany, and colleagues wrote in their study. “We found no association between antacid therapy and progression-free survival, mortality, or adverse events.”

In a post-hoc analysis, Kreuter and colleagues evaluated 291 IPF patients from three sets of trials (CAPACITY 004, CAPACITY 006, ASCEND) who underwent antacid therapy and compared them with 333 patients who did not undergo antacid therapy, according to the abstract. The researchers analyzed pulmonary function, survival, hospital admission, exercise tolerance and adverse events at baseline and for 52 weeks. The primary endpoint was defined as a decrease in forced vital capacity (FVC) of 10% or more, a decrease in the 6-minute walk distance (6MWD) or death.

At 52 weeks, there was no significant difference in disease progression (39% vs. 42%; P = 0.4844), all-cause mortality (7% vs. 7%; P = 0.8947), IPF-related mortality (4% vs. 5%; P = 0.4251), absolute FVC decrease by 10% or more (17% vs. 19%; P = 0.4411) and mean observed change in FVC (percent predicted = −4.9% vs. −5.5%; P = 0.3355), according to the abstract. There was a non-significant increase in hospital admission for the antacid group (65 patients; 22%) compared with the control group (54 patients; 16%) of patients (P = 0.0522). There was no significant difference between groups regarding mortality, disease progression, FVC, hospital admission and 6MWD when stratified by baseline FVC. There were similar rates of adverse events between both groups, although there was a higher infection rate among patients with more advanced IPF in the antacid therapy group (107 patients; 74%) compared with the control (101 patients; 62%) group (P = 0.0174) and a higher pulmonary infection rate in the antacid therapy (20 patients; 14%) group compared with the control (10 patients; 6%) group (P = 0.0214). – by Jeff Craven

Disclosure: Kreuter received grants and personal fees from Boehringer Ingelheim and InterMune/Roche. The other researchers report various financial disclosures. Please see the full study for a complete list of disclosures.