ASSOCIATION BETWEEN CLINICAL OUTCOMES AND BASELINE BMI OR ANNUALIZED WEIGHT LOSS IN PATIENTS WITH IDIOPATHIC PULMONARY FIBROSIS ENROLLED IN THE PULMONARY FIBROSIS FOUNDATION PATIENT REGISTRY

Abstract

SESSION TITLE: Diffuse Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Low baseline body mass index (BMI) and weight loss have been linked with poor outcomes in patients with idiopathic pulmonary fibrosis (IPF). This analysis investigated the association between clinical outcomes and baseline BMI or annualized change in body weight in patients with IPF enrolled in the Pulmonary Fibrosis Foundation Patient Registry (PFF-PR). METHODS: This analysis examined the relationship between (a) BMI group at enrollment (<25 kg/m2, 25 to <30 kg/m2 or ≥30 kg/m2) or annualized percent change in body weight group (no loss, >0% to <5% or ≥5%) and patient baseline characteristics, (b) BMI group at enrollment and clinical outcomes and (c) annualized percent change in body weight group and clinical outcomes. Outcomes included all-cause mortality at 24 months as well as changes from baseline to 24 months in lung function and exercise capacity, as assessed by percent predicted forced vital capacity (%FVC) and percent predicted diffusing capacity for carbon monoxide (%DLCO). Regression analyses were conducted with adjustment for age, sex, smoking history, oxygen use during exertion, pulmonary function, significant comorbidities and medications (pirfenidone, nintedanib and corticosteroids). RESULTS: As of February 14, 2020, 696 patients with IPF from the PFF-PR were eligible for the analysis. At enrollment, pulmonary arterial hypertension (PAH) was the only comorbidity that varied across weight-change categories (P=0.026), with 34 of 36 patients with PAH in the >0% to <5% annualized weight loss category. Logistic regression models did not indicate any difference in all-cause mortality between baseline BMI groups. Compared with patients with no weight loss, increased all-cause mortality was observed in patients with >0% to <5% and with ≥5% weight loss (odds ratios [95% CI], 5.4 [1.5, 34.4] and 5.4 [1.3, 36.9]). In the longitudinal analysis of %FVC and %DLCO, patients with baseline BMI <25 kg/m2 had a greater estimated annualized decline in %FVC than patients with baseline BMI ≥30 kg/m2 (difference [95% CI], 1.74% [0.47%, 3.0%]). A similar trend was also observed with %DLCO. There was no significant difference in annualized change of %FVC or %DLCO between groups defined by annualized percentage change in weight. CONCLUSIONS: Lower all-cause mortality was observed in patients with IPF with no annualized weight loss. Higher baseline BMI was associated with a lesser decline in lung function but not with lower all-cause mortality. CLINICAL IMPLICATIONS: Baseline BMI and annualized weight loss may be associated with clinical outcomes in patients with IPF. DISCLOSURES: Employee relationship with Genentech Please note: >$100000 Added 04/07/2020 by Cindy Burg, source=Web Response, value=Salary No relevant relationships by Elizabeth Freiheit, source=Web Response Consultant relationship with Boehringer Ingelheim Please note: $1001 - $5000 Added 04/07/2020 by Joyce Lee, source=Web Response, value=Consulting fee Consultant relationship with Genentech Please note: $1001 - $5000 Added 04/07/2020 by Joyce Lee, source=Web Response, value=Consulting fee Consultant relationship with Celgene Please note: $1001 - $5000 Added 04/07/2020 by Joyce Lee, source=Web Response, value=Consulting fee Consultant relationship with Galapagos Please note: $1001 - $5000 Added 04/07/2020 by Joyce Lee, source=Web Response, value=Consulting fee Consultant relationship with Eleven P15 Please note: $1001 - $5000 Added 04/07/2020 by Joyce Lee, source=Web Response, value=Consulting fee No relevant relationships by Adam Martin-Schwarze, source=Web Response Employee relationship with Genentech, Inc. Please note: >$100000 Added 04/07/2020 by Ming Yang, source=Web Response, value=Salary