Treatment Initiation in Patients with Interstitial Lung Disease in Canada
Deborah Assayag, Kristopher Garlick, Kerri A. Johannson, Charlene D. Fell, Martin Kolb, Gerard Cox, Nathan Hambly, H. Manganas, Julie Morisset, Jolene H. Fisher, Shane Shapera, Andrea S. Gershon, Teresa To, Mohsen Sadatsafavi, Pearce Wilcox, Andrew J. Halayko, Nasreen Khalil, Christopher J. Ryerson
Abstract
Abstract Rationale Real-life pharmacological treatment patterns of patients with interstitial lung diseases (ILD) remain elusive. Objectives To determine how often and with what medications patients with ILD are treated in Canadian tertiary care clinics. Methods All patients with ILD prospectively enrolled in the Canadian Registry for Pulmonary Fibrosis were included in this observational study. All first instances of medication for each patient were compiled. The time between the diagnosis of ILD and the first initiation of an ILD-related medication was compared across diagnostic categories. Cox proportional hazards models were used to identify variables associated with time-to-treatment initiation, stratified by diagnostic category. Results Out of 2,652 patients, a total of 1,483 (56%) were treated with an ILD-related medication during the median follow up of 3.0 years (1.4–5.9), including 349/646 (54%) patients with idiopathic pulmonary fibrosis (IPF) who received an antifibrotic. Patients with IPF were treated earlier and in greater proportion than those with non-IPF ILD (P = 0.001). Male sex and lower lung function were associated with shorter time-to-treatment initiation in the full cohort. Conclusions Overall, 56% of patients with ILD seen across seven Canadian specialized ILD clinics received pharmacological treatment over a median follow up of 3 years. Further studies are needed to assess longitudinal patterns of treatment and their influence on key outcomes.