Antifibrotic therapy alters the mortality risk associated with known biomarkers of idiopathic pulmonary fibrosis (IPF), according to research presented at the CHEST Annual Meeting 2019.
Previous studies have identified a number of circulating plasma biomarkers associated with mortality risk in patients with IPF; however, these studies were performed prior to the approval of antifibrotic agents.
Researchers followed patients from the University of California, Davis and University of Chicago who met international consensus criteria for IPF and provided a blood sample. Researchers assessed circulating levels of CA-125, CXCl-13, MMP-7, SPD, YKL-40, MMP-1, and VCAM-1 using the Luminex multiple assay.
A total of 293 patients were included, 70 of whom were exposed to antifibrotic therapy. After a median follow-up of 12 months, 92 patients (30%) died.
Increased levels of CXCl-13, MMP-7, SPD, YKL-40, MMp-1, and VCAM-1 were associated with increased mortality risk in patients who were not treated with antifibrotic agents, but this was not the case for those who were treated with these agents.
MMP-7 had the strongest differential mortality association in IPF. Patients with high levels of MMP-7 who did not receive antifibrotic therapy had an increased mortality risk (hazard ratio [HR], 2.48; 95% confidence interval [CI], 1.50-4.09; P<0.001); however, those who received antifibrotic therapy had a trend toward decreased mortality risk (HR=0.47; 95% CI, 0.18 to 1.19; P=0.10).
“These data raise the question of whether such biomarkers are of value in the era of antifibrotic therapy,” the authors concluded.
Oldham J, Alqalyoobi S, Adegunsoye A, et al. Anti-fibrotic therapy modulates mortality risk associated with circulating plasma biomarkers in patients with idiopathic pulmonary fibrosis. Presented at the CHEST Annual Meeting 2019. October 19-23, 2019; New Orleans, Louisiana.