Austin Health

Title
Gastroesophageal reflux and antacid therapy in IPF: analysis from the Australia IPF Registry.
Publication Date
2019-05-03
Author(s)
Jo, Helen E
Corte, Tamera J
Glaspole, Ian
Grainge, Christopher
Hopkins, Peter M A
Moodley, Yuben
Reynolds, Paul N
Chapman, Sally
Walters, E Haydn
Zappala, Christopher
Allan, Heather
Keir, Gregory J
Cooper, Wendy A
Mahar, Annabelle M
Ellis, Samantha
Macansh, Sacha
Goh, Nicole S L
Subject
Antacid
Cough
Gastroesophageal reflux disease
Idiopathic pulmonary fibrosis
Registry
Type of document
Journal Article
OrcId
0000-0003-1183-2729
0000-0003-2065-4346
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DOI
10.1186/s12890-019-0846-2
Abstract
Gastroesophageal reflux disease (GORD) is highly prevalent in idiopathic pulmonary fibrosis (IPF) and may play a role in its pathogenesis. Recent IPF treatment guidelines suggest that all patients with IPF be considered for antacid therapy. However, emerging evidence suggests that antacid therapy does not improve IPF patient outcomes and may increase the risk of pulmonary infection. Using prospectively collected data from the Australian IPF Registry including use of antacid therapy, GORD diagnosis and GORD symptoms, the relationship of these GORD variables to survival and disease progression was assessed. The severity of GORD symptoms using the frequency scale for symptoms of GORD (FSSG) and its relationships to outcomes was also assessed for the first time in an IPF cohort. Five hundred eighty-seven (86%) of the 684 patients in the Australian IPF Registry were eligible for inclusion. Patients were mostly male (69%), aged 71.0 ± 8.5 years with moderate disease (FVC 81.7 ± 21.5%; DLco 48.5 ± 16.4%). Most patients were taking antacids (n = 384; 65%), though fewer had a diagnosis of GORD (n = 243, 41.4%) and typical GORD symptoms were even less common (n = 171, 29.1%). The mean FSSG score was 8.39 ± 7.45 with 43% (n = 251) having a score > 8. Overall, there was no difference in survival or disease progression, regardless of antacid treatment, GORD diagnosis or GORD symptoms. Neither the use of antacid therapy nor the presence of GORD symptoms affects longer term outcomes in IPF patients. This contributes to the increasing evidence that antacid therapy may not be beneficial in IPF patients and that GORD directed therapy should be considered on an individual basis to treat the symptoms of reflux.
Link
Citation
BMC Pulmonary Medicine 2019; 19(1): 84
Jornal Title
BMC Pulmonary Medicine

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