PloS one
Institutional patterns in diagnosis and antifibrotic-era treatment uptake for IPF and PPF across U.S. centers
By Sheffield BA, Cassel BJ, Perelas A and 2 others.
Abstract
Purpose
For ten years, nintedanib and pirfenidone have been the only approved therapies for idiopathic pulmonary fibrosis (IPF), with nintedanib subsequently also approved for progressive pulmonary fibrosis (PPF). Previous studies demonstrate low antifibrotic (AF) uptake, but differences by site-of-care and AF uptake after seminal trials (IPF: INPULSIS/ASCEND; PPF: INBUILD) are not well characterized. We evaluated temporal trends in IPF and PPF diagnosis and AF use at academic (AC) versus non-academic (NonAC) centers.
Methods
Using the U.S. TriNetX Collaborative Network, we compared IPF and PPF incidence, prevalence, and AF use by center type using linear regression across post-trial and post-FDA-approval windows (IPF: 2015-2017, 2015-2024; PPF: 2020-2022, 2020-2024). Slope differences (Δslope) were calculated as AC minus NonAC annual slopes; therefore, positive values indicate faster increases at ACs, whereas negative values indicate faster increases at NonACs.