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Title: Gastroesophageal reflux and antacid therapy in IPF: analysis from the Australia IPF Registry.
Austin Authors: 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 
Affiliation: Institute for Breathing and Sleep
School of Medicine, Western Sydney University, Sydney, NSW, Australia
Department of Radiology, The Alfred Hospital, Melbourne, Victoria, Australia
Respiratory and Sleep Medicine
Department of Respiratory Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis, University of Sydney, Sydney, NSW, Australia
Department of Allergy and Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
Department of Respiratory Medicine, John Hunter Hospital, Newcastle, NSW, Australia
School of Medicine, University of Queensland, Brisbane, QLD, Australia
Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, QLD, Australia
Department of Respiratory Medicine, Fiona Stanley Hospital, Perth, WA, Australia
Department of Respiratory Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
University of Tasmania, Hobart, TAS, Australia
Department of Thoracic Medicine, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
Lung Foundation Australia, Brisbane, QLD, Australia
Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, QLD, Australia
Tissue pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
Issue Date: 3-May-2019
Date: 2019
Publication information: BMC Pulmonary Medicine 2019; 19(1): 84
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.
DOI: 10.1186/s12890-019-0846-2
ORCID: 0000-0003-1183-2729
Journal: BMC Pulmonary Medicine
PubMed URL: 31053121
Type: Journal Article
Subjects: Antacid
Gastroesophageal reflux disease
Idiopathic pulmonary fibrosis
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