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5. Detection and Early Referral of Patients With Interstitial Lung Abnormalities: An Expert Survey Initiative

Author

Abtin, Fereidoun, Antoniou, Katerina, Blackwell, Timothy, Brown, Kevin, Chung, Jonathan, Corte, Tamera, Crestani, Bruno, Crossno, Peter, Culver, Daniel, de Andrade, Joao, Deveraj, Anand, Flaherty, Kevin, Gudmundsson, Gunnar, Hatabu, Hiroto, Jacob, Joe, Johansson, Kerri, Kanne, Jeff, Kazerooni, Ella, Kolb, Martin, Lynch, David, Maher, Toby, Martinez, Fernando, Morais, Antonio, Nathan, Steven D., Noth, Imre, Oldham, Justin, Podolanczuk, Anna, Poletti, Venerino, Ravaglia, Claudia, Renzoni, Elizabetta, Richeldi, Luca, Rubin, Geoffrey, Ryerson, Chris, Sahoo, Debasis, Tomassetti, Sara, Spagnolo, Paolo, Strek, Mary E., Suh, Rob, Sverzellati, Nicola, Valeyre, Dominique, Walsh, Simon, Washko, George, White, Eric S., Hunninghake, Gary M., Goldin, Jonathan G., Kadoch, Michael A., Kropski, Jonathan A., Rosas, Ivan O., Wells, Athol U., Yadav, Ruchi, Lazarus, Howard M., Abtin, Fereidoun G., Corte, Tamera J., de Andrade, Joao A., Johannson, Kerri A., Kolb, Martin R., Lynch, David A., Oldham, Justin M., and Washko, George R.

Published
2022
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10. Cough-Specific Quality of Life Predicts Disease Progression Among Patients With Interstitial Lung Disease: Data From the Pulmonary Fibrosis Foundation Patient Registry

Author

Bascom, Rebecca, Belloli, Elizabeth, Bhatt, Nitin, Bhorade, Sangeeta, Case, Amy, Castriotta, Richard, Criner, Gerard, Danoff, Sonye, De Andrade, Joao, Desai, Alpa, Glassberg, Marilyn, Glazer, Craig, Gulati, Mridu, Gupta, Nishant, Hamblin, Mark, Huie, Tristan, Kaner, Robert, Kass, Daniel, Kim, Hyun, Kreider, Maryl, Lancaster, Lisa, Lasky, Joseph, Limper, Andrew, Montesi, Sydney, Mooney, Joshua, Morrison, Lake, Nambiar, Anoop, Nathan, Steven, Natt, Bhupinder, Paul, Tessy, Perez, Rafael, Podolanczuk, Anna, Raghu, Ganesh, Scholand, Mary Beth, Shifren, Adrian, Strek, Mary, Todd, Nevins, Walia, Rajat, Weight, Stephen, Whelan, Timothy, Wolters, Paul, Lee, Janet, White, Emily, Freiheit, Elizabeth, Strek, Mary E., Podolanczuk, Anna J., and Patel, Nina M.

Published
2022
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13. Association of Circulating Proteins with Death or Lung Transplant in Patients with Idiopathic Pulmonary Fibrosis in the IPF-PRO Registry Cohort

Author

Todd, Jamie L., Neely, Megan L., Overton, Robert, Mulder, Hillary, Roman, Jesse, Lasky, Joseph A., and de Andrade, Joao A.

Subjects
Boehringer Ingelheim Pharmaceuticals Inc., Transplantation of organs, tissues, etc. -- Analysis, Medical research -- Analysis, Medicine, Experimental -- Analysis, Pulmonary fibrosis -- Care and treatment -- Prognosis, Medical colleges -- Analysis, Proteins -- Analysis, Pharmaceutical industry -- Analysis, Health
Abstract

Idiopathic pulmonary fibrosis (IPF) is a progressive and ultimately fatal disease with a variable clinical course. Biomarkers that predict patient outcomes are needed. We leveraged data from 300 patients in the multicenter IPF-PRO Registry to determine associations between circulating proteins and the composite outcome of respiratory death or lung transplant. Plasma collected at enrollment was analyzed using aptamer-based proteomics (1305 proteins). Over a median follow-up of 30.4 months, there were 76 respiratory deaths and 26 lung transplants. In unadjusted univariable analyses, 61 proteins were significantly associated with the outcome (hazard ratio > 2 or < 0.5, corrected p [less than or equal to] 0.05). In multivariable analyses, a set of 4 clinical measures and 47 unique proteins predicted the probability of respiratory death or lung transplant with an optimism-corrected C-index of 0.76. Our results suggest that select circulating proteins strongly associate with the risk of mortality in patients with IPF and confer information independent of clinical measures., Author(s): Jamie L. Todd [sup.1] [sup.2], Megan L. Neely [sup.1] [sup.2], Robert Overton [sup.1], Hillary Mulder [sup.1], Jesse Roman [sup.3], Joseph A. Lasky [sup.4], Joao A. de Andrade [sup.5], Mridu [...]

Published
2022
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17. An automated flowchart for the Modified Rankin Scale assessment: A multicenter inter-rater agreement analysis.

Author

C de Andrade, Joao Brainer, Quinn, Terence J, Carbonera, Leonardo Augusto, Montanaro, Vinicius Viana Abreu, Robles, Alexandre C, Pádua Gomes, Rafael, Ribeiro, Saulo, and Sampaio Silva, Gisele

Abstract

Background and objective: The Modified Rankin Scale (mRS) is a widely adopted scale for assessing stroke recovery. Despite limitations, the mRS has been adopted as primary outcome in most recent clinical acute stroke trials. Designed to be used by multidisciplinary clinical staff, the congruency of this scale is not consistent, which may lead to mistakes in clinical or research application. We aimed to develop and validate an interactive and automated digital tool for assessing the mRS—the iRankin. Methods: A panel of five board-certified and mRS-trained vascular neurologists developed an automated flowchart based on current mRS literature. Two international experts were consulted on content and provided feedback on the prototype platform. The platform contained five vignettes and five real video cases, representing mRS grades 0–5. For validation, we invited neurological staff from six comprehensive stroke centers to complete an online assessment. Participants were randomized into two equal groups usual practice versus iRankin. The participants were randomly allocated in pairs for the congruency analysis. Weighted kappa (kw) and proportions were used to describe agreement. Results: A total of 59 professionals completed the assessment. The kw was dramatically improved among nurses, 0.76 (95% confidence interval (CI) = 0.55–0.97) × 0.30 (0.07–0.67), and among vascular neurologists, 0.87 (0.72–1) × 0.82 (0.66–0.98). In the accuracy analysis, after the standard mRS values for the vignettes and videos were determined by a panel of experts, and considering each correct answer as equivalent to 1 point on a scale of 0–15, it revealed a higher mean of 10.6 (±2.2) in the iRankin group and 8.2 (±2.3) points in the control group (p = 0.02). In an adjusted analysis, the iRankin adoption was independently associated with the score of congruencies between reported and standard scores (beta coefficient = 2.22, 95% CI = 0.64–3.81, p = 0.007). Conclusion: The iRankin adoption led to a substantial or near-perfect agreement in all analyzed professional categories. More trials are needed to generalize our findings. Our user-friendly and free platform is available at https://www.irankinscale.com/. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Predicting hemorrhagic transformation in patients not submitted to reperfusion therapies

Author

de Andrade, Joao Brainer Clares, Mohr, Jay P., Lima, Fabricio Oliveira, Carvalho, Joao José de Freitas, de Farias, Victor Aguiar Evangelista, Oliveira-Filho, Jamary, Pontes-Neto, Octavio Marques, Bazan, Rodrigo, Merida, Kristel Larisa Back, Franciscato, Luisa, Pires, Matheus Mendes, Modolo, Gabriel Pinheiro, Marques, Mayara Silva, Miranda, Renata Carolina Acri Nunes, and Silva, Gisele Sampaio

Published
2020
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20. Disease Severity and Quality of Life in Patients With Idiopathic Pulmonary Fibrosis: A Cross-Sectional Analysis of the IPF-PRO Registry

Author

Asi, Wael, Baker, Albert, Beegle, Scott, Belperio, John A., Condos, Rany, Cordova, Francis, Culver, Daniel A., de Andrade, Joao A.M., Dilling, Daniel, Flaherty, Kevin R., Glassberg, Marilyn, Gulati, Mridu, Guntupalli, Kalpalatha, Gupta, Nishant, Hajari Case, Amy, Hotchkin, David, Huie, Tristan, Kaner, Robert, Kim, Hyun, Kreider, Maryl, Lancaster, Lisa, Lasky, Joseph, Lederer, David, Lee, Doug, Liesching, Timothy, Lipchik, Randolph, Lobo, Jason, Mageto, Yolanda, Menon, Prema, Morrison, Lake, Namen, Andrew, Oldham, Justin, Raj, Rishi, Ramaswamy, Murali, Russell, Tonya, Sachs, Paul, Safdar, Zeenat, Sigal, Barry, Silhan, Leann, Strek, Mary, Suliman, Sally, Tabak, Jeremy, Walia, Rajat, Whelan, Timothy P., O’Brien, Emily C., Hellkamp, Anne S., Neely, Megan L., Swaminathan, Aparna, Bender, Shaun, Snyder, Laurie D., Conoscenti, Craig S., Todd, Jamie L., Palmer, Scott M., and Leonard, Thomas B.

Published
2020
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22. Unveiling Biological Age: A New Frontier in Predicting Outcomes in Chronic Lung Disease.

Author

de Andrade, Joao A., Agudelo Garcia, Paula A., and Mora, Ana L.

Subjects
LUNG diseases, CHRONIC diseases, HEART failure, OVARIAN cancer
Abstract

The authors discuss a study by J. V. Pugashetti and colleagues published in the issue which challenged the simplistic association of chronological age and disease outcome, delving into the concept of biological age. Topics include the researchers' core hypothesis, findings on biological age, as measured by specific protein markers of systemic physiological and homeostatic decline, and implications of the findings for future research and clinical care.

Published
2024
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41. Design and rationale for the prospective treatment efficacy in IPF using genotype for NAC selection (PRECISIONS) clinical trial.

Author

Podolanczuk, Anna J., Kim, John S., Cooper, Christopher B., Lasky, Joseph A., Murray, Susan, Oldham, Justin M., Raghu, Ganesh, Flaherty, Kevin R., Spino, Cathie, Noth, Imre, Martinez, Fernando J., for the PRECISIONS Study Team, Freiheit, Elizabeth, Martin-Schwarze, Adam, Szparza, Ashley, Naik, Tanvi, Edwards, Rex, Bernard, Gordon, Barnbaum, Deborah, and de Andrade, Joao

Subjects
TREATMENT effectiveness, CLINICAL trials, IDIOPATHIC pulmonary fibrosis, VITAL capacity (Respiration), THERAPEUTICS
Abstract

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with few treatment options. N-acetylcysteine (NAC) is a well-tolerated, inexpensive treatment with antioxidant and anti-fibrotic properties. The National Heart, Lung, and Blood Institute (NHLBI)-sponsored PANTHER (Prednisone Azathioprine and NAC therapy in IPF) trial confirmed the harmful effects of immunosuppression in IPF, and did not show a benefit to treatment with NAC. However, a post hoc analysis revealed a potential beneficial effect of NAC in a subgroup of individuals carrying a specific genetic variant, TOLLIP rs3750920 TT genotype, present in about 25% of patients with IPF. Here, we present the design and rationale for the Phase III, multi-center, randomized, double-blind, placebo-controlled Prospective Treatment Efficacy in IPF Using Genotype for NAC Selection (PRECISIONS) clinical trial. Methods: The PRECISIONS trial will randomize 200 patients with IPF and the TOLLIP rs3750920 TT genotype 1:1 to oral N-acetylcysteine (600 mg tablets taken three times a day) or placebo for a 24-month duration. The primary endpoint is the composite of time to 10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplantation, or death from any cause. Secondary endpoints include change in patient-reported outcome scores and proportion of participants with treatment-emergent adverse events. Biospecimens, including blood, buccal, and fecal will be collected longitudinally for future research purposes. Study participants will be offered enrollment in a home spirometry substudy, which explores time to 10% relative FVC decline measured at home, and its comparison with study visit FVC. Discussion: The sentinel observation of a potential pharmacogenetic interaction between NAC and TOLLIP polymorphism highlights the urgent, unmet need for better, molecularly focused, and precise therapeutic strategies in IPF. The PRECISIONS clinical trial is the first study to use molecularly-focused techniques to identify patients with IPF most likely to benefit from treatment. PRECISIONS has the potential to shift the paradigm in how trials in this condition are designed and executed, and is the first step toward personalized medicine for patients with IPF. Trial Registration ClinicalTrials.gov identifier: NCT04300920. Registered March 9, 2020. https://clinicaltrials.gov/ct2/show/NCT04300920 [ABSTRACT FROM AUTHOR]

Published
2022
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43. Connective tissue disease related interstitial lung diseases and idiopathic pulmonary fibrosis: provisional core sets of domains and instruments for use in clinical trials

Author

Saketkoo, Lesley Ann, Mittoo, Shikha, Huscher, Dörte, Khanna, Dinesh, Dellaripa, Paul F, Distler, Oliver, Flaherty, Kevin R, Frankel, Sid, Oddis, Chester V, Denton, Christopher P, Fischer, Aryeh, Kowal-Bielecka, Otylia M, LeSage, Daphne, Merkel, Peter A, Phillips, Kristine, Pittrow, David, Swigris, Jeffrey, Antoniou, Katerina, Baughman, Robert P, Castelino, Flavia V, Christmann, Romy B, Christopher-Stine, Lisa, Collard, Harold R, Cottin, Vincent, Danoff, Sonye, Highland, Kristin B, Hummers, Laura, Shah, Ami A, Kim, Dong Soon, Lynch, David A, Miller, Frederick W, Proudman, Susanna M, Richeldi, Luca, Ryu, Jay H, Sandorfi, Nora, Sarver, Catherine, Wells, Athol U, Strand, Vibeke, Matteson, Eric L, Brown, Kevin K, Seibold, James R, Aggarwal, Rohit, Ainslie, Gillian, Alkassab, Firas, Allanore, Yannick, Descartes, Paris, Anderson, Marina E, Andonopoulos, Andrew P, Antin-Ozerkis, Danielle, Arrobas, Ana, Ascherman, Dana P, Assassi, Shervin, Baron, Murray, Bathon, Joan M, Behr, Juergen, Beretta, Lorenzo, Bingham, Clifton O, III, Binnie, Matthew, Birring, Surinder S, Boin, Francesco, Bongartz, Tim, Bourdin, Arnaud, Bouros, Demosthenes, Brasington, Richard, Bresser, Paul, Buch, Maya H, Burge, P Sherwood, Carmona, Loreto, Carreira, Patricia E, Carvalho, Carlos RR, Catoggio, Luis J, Chan, Kevin M, Chapman, Jeffrey, Chatterjee, Soumya, Chua, Felix, Chung, Lorinda, Conron, Matthew, Corte, Tamera, Cosgrove, Gregory, Costabel, Ulrich, Cox, Gerard, Crestani, Bruno, Crofford, Leslie J, Csuka, Mary E, Curbelo, Pablo, László, Czirják, Daniil, Zoe, DʼArsigny, Christine L, Davis, Gerald S, de Andrade, Joao A, De Vuyst, Paul, Dempsey, Owen J, Derk, Chris T, Distler, Jörg, Dixon, William G, Downey, Gregory, Doyle, Mittie K, Drent, Marjolein, Durairaj, Lakshmi, Emery, Paul, Espinoza, Luis R, Farge, Dominique, Fathi, Maryam, Fell, Charlene D, Fessler, Barri J, Fitzgerald, John E, Fox, George A, Foeldvari, Ivan, Frech, Tracy M, Freitas, Sara, Furst, Daniel E, Gabrielli, Armando, García-Vicuña, Rosario, Georgiev, Ognian B, Gerbino, Anthony, Gillisen, Adrian, Gladman, Dafna D, Glassberg, Marilyn, Gochuico, Bernadette R, Gogali, Athena, Goh, Nicole S, Goldberg, Avram, Goldberg, Hilary J, Gourley, Mark F, Griffing, Leroy, Grutters, Jan C, Gunnarsson, Ragnar, Hachulla, Eric, Hall, Frances C, Harari, Sergio, Herrick, Ariane L, Herzog, Erica L, Hesselstrand, Roger, Hirani, Nikhil, Hodgson, Ulla, Hollingsworth, Helen M, Homer, Robert J, Hoyles, Rachel K, Hsu, Vivien M, Hubbard, Richard B, Hunzelmann, Nicolas, Isasi, Maria Eloisa, Isasi, Elida Susana, Sergio A Jimenez, Jacobsen Soren, Johnson, Sindhu R, Jones, Christine H, Kahaleh, Bashar, Kairalla, Ronaldo A, Kalluri, Meena, Kalra, Sanjay, Kaner, Robert J, Kinder, Brent W, Klingsberg, Ross C, Kokosi, Maria, RJ Kolb, Martin, Kur-Zalewska, Joanna, Kuwana, Masataka, Lake, Fiona R, Lally, Edward V, Lasky, Joseph A, Laurindo, Ileda M, Able, Lawrence, Lee, Peter, Leonard, Colm T, Lien, Dale C, Limper, Andrew H, Liossis, Stamatis-Nick C, Lohr, Kristine M, Loyd, James E, Lundberg, Ingrid E, Mageto, Yolanda N, Maher, Toby M, Mahmud, Tafazzul H, Manganas, Helene, Marie, Isabelle, Marras, Theodore K, Antônio Baddini Martinez, José, Martinez, Fernando J, Mathieu, Alessandro, Matucci-Cerinic, Marco, Mayes, Maureen D, McKown, Kevin M, Medsger, Thomas A, Jr., Meehan, Richard T, Cristina, Mendes Ana, Meyer, Keith C, Millar, Ann B, Moğulkoç, Nesrin, Molitor, Jerry A, Morais, António, Luc Mouthon, Portugal, Müller, Veronika, Müller-Quernheim, Joachim, Nadashkevich, Oleg, Nador, Roland, Nash, Peter, Nathan, Steven D, Navarro, Carmen, Neves, Sofia, Noth, Imre, Nunes, Hilario, Olson, Amy L., Opitz, Christian F, Padilla, Maria, Pappas, Dimitrios, Parfrey, Helen, Pego-Reigosa, José M, AC Pereira, Carlos, Perez, Rafael, Pope, Janet E, Porter, Joanna C., Renzoni, Elisabeth A, Riemekasten, Gabriela, Riley, David J, Rischmueller, Maureen, Rodriguez-Reyna, Tatiana S, Rojas-Serrano, Romam, Jesse, Rosen, Glenn D, Rossman, Milton, Rothfield, Naomi, Sahn, Steven A, Sanduzzi, Alessandro, Scholand, Mary Beth, Selman, Moises, Senécal, Jean-Luc, Seo, Philip, Silver, Richard M, Solomon, Joshua J, Steen, Virginia, Stevens, Wendy, Strange, Charlie, Sussman, Robert, Sutton, Evelyn D, Sweiss, Nadera J, Tornling, Göran, Tzelepis, George E, Undurraga, Alvaro, Vacca, Allessandra, Vancheri, Carlo, Varga, Janos, Veale, Douglas J, Volkov, Suncica, Walker, Ulrich A, Wencel, Mark, Wesselius, Lewis J, Wickremasinghe, Melissa, Wilcox, Pearce, Wilsher, Margaret L, Wollheim, Frank A, Wuyts, Wim A, Yung, Gordon, Zanon, Pietro, Zappala, Christopher J, Groshong, Steve D, Leslie, Kevin O, Myers, Jeffrey L, Padera, Robert F, R Desai, Sujal, Goldin, Jonathan, Kazerooni, Ella A, Klein, Jeffrey S, Lynch, David A, and Keen, Kevin J

Published
2014
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45. Treatment of Idiopathic Pulmonary Fibrosis With Ambrisentan: A Parallel, Randomized Trial

Author

Raghu, Ganesh, Behr, Juergen, Brown, Kevin K., Egan, Jim J., Kawut, Steven M., Flaherty, Kevin R., Martinez, Fernando J., Nathan, Steven D., Wells, Athol U., Collard, Harold R., Costabel, Ulrich, Richeldi, Luca, de Andrade, Joao, Khalil, Nasreen, Morrison, Lake D., Lederer, David J., Shao, Lixin, Li, Xiaoming, Pedersen, Patty S., Montgomery, A. Bruce, Chien, Jason W., and OʼRiordan, Thomas G.

Published
2013

48. Detection and Early Referral of Patients With Interstitial Lung Abnormalities: An Expert Survey Initiative.

Author

Hunninghake, Gary M., Goldin, Jonathan G., Kadoch, Michael A., Kropski, Jonathan A., Rosas, Ivan O., Wells, Athol U., Yadav, Ruchi, Lazarus, Howard M., Abtin, Fereidoun G., Corte, Tamera J., de Andrade, Joao A., Johannson, Kerri A., Kolb, Martin R., Lynch, David A., Oldham, Justin M., Spagnolo, Paolo, Strek, Mary E., Tomassetti, Sara, Washko, George R., and White, Eric S.

Subjects
MEDICAL referrals, INTERSTITIAL lung diseases, PULMONARY function tests, LUNGS, COMPUTED tomography
Abstract

Background: Interstitial lung abnormalities (ILA) may represent undiagnosed early-stage or subclinical interstitial lung disease (ILD). ILA are often observed incidentally in patients who subsequently develop clinically overt ILD. There is limited information on consensus definitions for, and the appropriate evaluation of, ILA. Early recognition of patients with ILD remains challenging, yet critically important. Expert consensus could inform early recognition and referral.Research Question: Can consensus-based expert recommendations be identified to guide clinicians in the recognition, referral, and follow-up of patients with or at risk of developing early ILDs?Study Design and Methods: Pulmonologists and radiologists with expertise in ILD participated in two iterative rounds of surveys. The surveys aimed to establish consensus regarding ILA reporting, identification of patients with ILA, and identification of populations that might benefit from screening for ILD. Recommended referral criteria and follow-up processes were also addressed. Threshold for consensus was defined a priori as ≥ 75% agreement or disagreement.Results: Fifty-five experts were invited and 44 participated; consensus was reached on 39 of 85 questions. The following clinically important statements achieved consensus: honeycombing and traction bronchiectasis or bronchiolectasis indicate potentially progressive ILD; honeycombing detected during lung cancer screening should be reported as potentially significant (eg, with the Lung CT Screening Reporting and Data System "S-modifier" [Lung-RADS; which indicates clinically significant or potentially significant noncancer findings]), recommending referral to a pulmonologist in the radiology report; high-resolution CT imaging and full pulmonary function tests should be ordered if nondependent subpleural reticulation, traction bronchiectasis, honeycombing, centrilobular ground-glass nodules, or patchy ground-glass opacity are observed on CT imaging; patients with honeycombing or traction bronchiectasis should be referred to a pulmonologist irrespective of diffusion capacity values; and patients with systemic sclerosis should be screened with pulmonary function tests for early-stage ILD.Interpretation: Guidance was established for identifying clinically relevant ILA, subsequent referral, and follow-up. These results lay the foundation for developing practical guidance on managing patients with ILA. [ABSTRACT FROM AUTHOR]

Published
2022
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49. Impact of timing of nintedanib initiation among patients newly diagnosed with idiopathic pulmonary fibrosis.

Author

Singer, David, Bengtson, Lindsay G. S., Conoscenti, Craig S., Anderson, Amy J., Brekke, Lee, Shetty, Sharash S., and de Andrade, Joao

Abstract

While nintedanib treatment has been shown to slow the progression of idiopathic pulmonary fibrosis (IPF) in patients across varying levels of lung function, the effect of treatment timing on outcomes has not been examined. We assessed hospitalization risk and medical costs among patients with IPF based on the timing of nintedanib initiation after IPF diagnosis. This retrospective administrative claims study included data from 04/01/2014–09/30/2019 for patients aged ≥40 years who initiated nintedanib within 1 year of IPF diagnosis. Patients were assigned to study cohorts based on the time from IPF diagnosis to nintedanib initiation. All-cause hospitalization and all-cause medical costs were modeled using marginal structural models including inverse probability weights to adjust for both baseline and time-varying characteristics. Of 11,195 patients diagnosed with IPF during the identification period, 449 met the study selection criteria (mean age 72.3 years, 68% male, mean follow-up time 13.3 months). Adjusted hospitalization risk and medical costs both varied significantly by the timing of nintedanib initiation (p <.001 and p =.020, respectively). Adjusted weighted hospitalization risk was higher among untreated vs. treated patients in months 2–3, months 4–6, and months 7–12 after diagnosis (hazard ratio [95% CI] 1.97 [1.09–3.56], p =.026; 2.62 [1.22–5.63], p =.014; and 5.57 [2.31–13.45], p <.001, respectively). Medical costs were 69% higher for patients initiating treatment in months 2–3 vs. month 1 (cost ratio [95% CI] 1.69 [1.20–2.38], p =.003). Disease severity could not be assessed because clinical data were unavailable; however, proxies such as oxygen use were included to adjust for between-cohort differences in disease severity. Patients who initiate nintedanib promptly after IPF diagnosis may have reduced hospitalization risk and medical costs compared with those who start treatment later. Additional studies are warranted to improve understanding of the impact of prompt antifibrotic therapy on patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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