Pulmonary rehab completion rates, responses similar for patients with IPF, COPD

Patients with idiopathic pulmonary fibrosis have similar magnitudes of response and completion rates for pulmonary rehabilitation compared with patients with COPD, according to a real-world study published in Chest.

“There is limited evidence to support pulmonary rehabilitation for people with IPF and international and national clinical guidelines have provided conflicting recommendations on this topic,” Claire M. Nolan, PhD, senior research physiotherapist of the respiratory research group at Harefield Hospital, England, told Healio. In this study, “compared with pulmonary rehabilitation responders, pulmonary rehabilitation noncompletion and nonresponse were independently associated with all-cause mortality at 1 year in [patients with] IPF.”

The real-world study matched 163 patients with IPF (mean age, 73 years; 67% men) with 163 controls with COPD (mean age, 73 years; 68% men) referred for pulmonary rehabilitation. Researchers compared pulmonary rehabilitation completion rates and responses between both groups and recorded survival among patients with IPF during 1-year after rehabilitation discharge.

Patients with IPF and COPD had similar completion rates for pulmonary rehabilitation (69% vs. 63%; P = .24).

In addition, researchers observed similar improvements in exercise response among patients with IPF and patients with COPD, with no significant mean between-group differences in the incremental shuttle walk test change (IPF, 53 m vs. COPD, 55 m; P < .001).

Pulmonary rehabilitation noncompletion (HR = 5.62; 95% CI, 2.24-14.08) and nonresponse (HR = 3.91; 95% CI, 1.54-9.93) were independently associated with increased 1-year all-cause mortality among patients with IPF (P = .01 for both).

When patients were stratified as pulmonary rehabilitation responders, nonresponders and noncompleters, the researchers reported a greater proportion of noncompleters and nonresponders died 1 year after rehabilitation compared with responders (40% and 24%, respectively vs. 10%; P < .01).

“A novel finding of our study is that pulmonary rehabilitation may confer prognostic benefits in IPF, which deserves further investigation,” Nolan said. “Further work is required to corroborate these findings. Nonetheless, these data reinforce the importance of referral to and engagement in pulmonary rehabilitation amongst the IPF population.”

For more information:

Claire M. Nolan, PhD, can be reached at c.nolan@rbht.nhs.uk.