Work

Predictive value of Eastern Cooperative Oncology Group performance status and body mass index for antifibrotic tolerability and prognosis in patients with idiopathic pulmonary fibrosis

Year: 2025

Type: article

Abstract: BACKGROUND: Antifibrotics are key to prolonging survival in patients with idiopathic pulmonary fibrosis (IPF). Although no satisfactory index has been established to predict the tolerability of antifibrotics, Eastern Cooperative Oncology Group (ECOG) performance status (PS) has been suggested as an indicator. This study aimed to investigate potential predictive factors for the tolerability of antifibrotics in patients with IPF. METHODS: This dual-centre retrospective study enrolled Japanese patients with IPF treated with nintedanib or pirfenidone between 2010 and 2019. RESULTS: Among 150 enrolled patients, 51 were excluded, yielding a final cohort of 99. The distribution of patients across ECOG PS stages 0, 1, 2, 3, and 4 was 40, 38, 16, 5, and 0, respectively. Multivariate Cox analysis indicated that ECOG PS and body mass index (BMI) were significant predictors of treatment duration (P = 0.04, P < 0.01, respectively), whereas the gender-age-physiology index was not. The correlation between the ECOG PS stage and BMI was weak (ρ = -0.243, P < 0.015). We created a composite index-ECOG PS plus BMI (0-2)-by combining ECOG PS (0-1, 0; 2-4, 1) and BMI (>19.97, 0; ≤ 19.97, 1), which stratified the patients into three groups with distinct treatment durations and overall survival patterns. ECOG PS and BMI may be useful for recognising stages of IPF in older and non-older adults. CONCLUSIONS: ECOG PS and BMI are promising indicators of antifibrotic tolerability and prognosis of patients with IPF in a Japanese population.

Source: Respiratory Medicine

DOI: 10.1016/j.rmed.2025.108520