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Volume 88
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10.5603/ARM.a2020.0137
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Advances in Respiratory Medicine is published by MDPI from Volume 90 Issue 4 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Via Medica.
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Article

The Gender–Age–Physiology System as a Prognostic Model in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib: A Longitudinal Cohort Study

by
Mitsuhiro Abe
1,*,
Kenji Tsushima
2,
Keiichiro Yoshioka
1,
Masashi Sakayori
1,
Kenichi Suzuki
1,
Yasutaka Hirasawa
1,
Takeshi Kawasaki
1,
Jun Ikari
1,
Jiro Terada
1 and
Koichiro Tatsumi
1
1
Department of Respirology, Graduate School of Medicine, Chiba University , Chiba, Japan
2
Department of Pulmonary Medicine, International University of Health and Welfare, School of Medicine, Chiba, Japan
*
Author to whom correspondence should be addressed.
Adv. Respir. Med. 2020, 88(5), 369-376; https://doi.org/10.5603/ARM.a2020.0137
Submission received: 13 February 2020 / Revised: 24 May 2020 / Accepted: 24 May 2020 / Published: 24 October 2020

Abstract

Introduction: The Gender-Age-Physiology (GAP) system is a tool for predicting prognosis in patients with idiopathic pulmonary fibrosis (IPF). Yet, to date, the GAP system has not been evaluated in patients with IPF who received nintedanib. Material and methods: This single-center retrospective study included 89 patients with IPF who received Nintedanib for at least 3 months. All-cause mortality was set as the end point. Clinical parameters, including the GAP stage, were statistically analyzed for risk factors leading to mortality using the Cox proportional hazard model. Results: The median follow-up was 16.4 months (range 3.7–37.4 months), during which 23 patients died. Univariate analysis revealed that the GAP stage (hazard ratio [HR] 3.00, 95% confidence interval [CI] 1.52–5.92, p = 0.0014) and PaO2 (HR 0.95, 95% CI 0.92–0.98, p = 0.0063) were significant prognostic factors. Multivariate analysis revealed that the GAP stage was a significant prognostic factor (HR 2.26, 95% CI 1.07–4.78, p = 0.031). Log-rank analysis revealed that there were no significant differences in “Gender” (p = 0.47) and “Age” (p = 0.18) factors. However, there were significant differences in “Physiology” factors (% of forced vital capacity, p = 0.018; % of diffusing capacity of lung carbon monoxide, p < 0.001). The cumulative incidences of mortality at 1 and 2 years were as follows: GAP I: 5.1% and 6.8%; GAP II: 9.5% and 29.3%; and GAP III: 18.9% and 84.2%. Conclusions: The GAP system is useful as a prognostic tool in patients with IPF who have been treated with nintedanib.
Keywords: diffusing capacity of lung carbon monoxide; forced vital capacity; GAP stage; idiopathic pulmonary fibrosis; nintedanib diffusing capacity of lung carbon monoxide; forced vital capacity; GAP stage; idiopathic pulmonary fibrosis; nintedanib

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MDPI and ACS Style

Abe, M.; Tsushima, K.; Yoshioka, K.; Sakayori, M.; Suzuki, K.; Hirasawa, Y.; Kawasaki, T.; Ikari, J.; Terada, J.; Tatsumi, K. The Gender–Age–Physiology System as a Prognostic Model in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib: A Longitudinal Cohort Study. Adv. Respir. Med. 2020, 88, 369-376. https://doi.org/10.5603/ARM.a2020.0137

AMA Style

Abe M, Tsushima K, Yoshioka K, Sakayori M, Suzuki K, Hirasawa Y, Kawasaki T, Ikari J, Terada J, Tatsumi K. The Gender–Age–Physiology System as a Prognostic Model in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib: A Longitudinal Cohort Study. Advances in Respiratory Medicine. 2020; 88(5):369-376. https://doi.org/10.5603/ARM.a2020.0137

Chicago/Turabian Style

Abe, Mitsuhiro, Kenji Tsushima, Keiichiro Yoshioka, Masashi Sakayori, Kenichi Suzuki, Yasutaka Hirasawa, Takeshi Kawasaki, Jun Ikari, Jiro Terada, and Koichiro Tatsumi. 2020. "The Gender–Age–Physiology System as a Prognostic Model in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib: A Longitudinal Cohort Study" Advances in Respiratory Medicine 88, no. 5: 369-376. https://doi.org/10.5603/ARM.a2020.0137

APA Style

Abe, M., Tsushima, K., Yoshioka, K., Sakayori, M., Suzuki, K., Hirasawa, Y., Kawasaki, T., Ikari, J., Terada, J., & Tatsumi, K. (2020). The Gender–Age–Physiology System as a Prognostic Model in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib: A Longitudinal Cohort Study. Advances in Respiratory Medicine, 88(5), 369-376. https://doi.org/10.5603/ARM.a2020.0137

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