Cardiovascular Burden and Medication Use Among Patients With Idiopathic Pulmonary Fibrosis

Abstract

SESSION TITLE: Evaluation and Treatment of ILD SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM PURPOSE: Patients with idiopathic pulmonary fibrosis (IPF) often have a number of cardiovascular risk factors and comorbidities and take a variety of related concomitant medications. The objective of this analysis was to describe the type and prevalence of specific cardiovascular risk factors/comorbidities and related medication use in patients with IPF. METHODS: We conducted a descriptive cross-sectional analysis using a large US commercial insurance claims database to identify a cohort of patients with IPF between 2009 and 2011. We included patients with ≥ 1 inpatient claim or ≥ 2 outpatient claims with IPF (ICD-9-CM code 516.3) as one of the listed diagnoses and continuous enrollment during the identification (ID) year. Patients who had another type of interstitial lung disease after their last IPF claim in the ID year were excluded. Measures that were reported in the ID year included age, sex, health plan, usual physician specialty and cardiovascular risk factors/comorbidities and related medication use (over-the-counter medications such as aspirin were not captured). We generated descriptive results for the combined and individual ID years. RESULTS: We identified 3619 patients with IPF from 2009 to 2011: 1191 in 2009, 1292 in 2010 and 1136 in 2011. Mean (standard deviation) age was 70.4 (11.0) years, 50.5% were women, 62.6% had Medicare coverage and 49.5% received usual IPF care from a pulmonologist. Cardiovascular risk factors/comorbidities were common among patients with IPF, with ischemic heart disease being the most prevalent condition (35.7%) followed by congestive heart failure (26.8%), cerebrovascular disease (15.7%), peripheral vascular disease (11.0%), diabetes with chronic complications (9.4%), pulmonary hypertension (8.6%) and myocardial infarction (7.3%). Use of cardiovascular-related medication was evident for three-quarters of patients (74.6%): anti-hyperlipidemics (46.8%), diuretics (37.6%), renin-angiotensin inhibitors (35.5%), beta blockers (33.0%), calcium channel blockers (24.3%), anti-thrombotic agents (23.2%), anti-diabetic agents (21.6%), nitrates (9.3%), smoking cessation drugs (4.3%), anti-arrhythmic agents (3.5%) and pulmonary hypertension agents (3.0%). Results by ID year showed similar patterns. CONCLUSIONS: Cardiovascular risk factors/comorbidities and related medication use were highly prevalent among patients with IPF. These considerations should be taken into account in the overall management of patients with IPF. CLINICAL IMPLICATIONS: It is important to assess cardiovascular risk factors/comorbidities and concomitant use of related medications in the management of patients with IPF. DISCLOSURE: Karina Raimundo: Employee: Genentech, Inc. Michael Broder: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech Eunice Chang: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech Sheila Reddy: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech Elya Papoyan: Employee: Partnership for Health Analytic Research, LLC, paid by Genentech John Stauffer: Employee: Genentech, Inc. No Product/Research Disclosure Information