Gastroesophageal reflux and antacid therapy in IPF: Analysis from the Australia IPF Registry

Helen E. Jo, Tamera J. Corte, Ian Glaspole, Christopher Grainge, Peter M.A. Hopkins, Yuben Moodley, Paul N. Reynolds, Sally Chapman, E. Haydn Walters, Christopher Zappala, Heather Allan, Gregory J. Keir, Wendy A. Cooper, Annabelle M. Mahar, Samantha Ellis, Sacha MacAnsh, Nicole S. Goh

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background and objective: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Article number84
Number of pages7
JournalBMC Pulmonary Medicine
Volume19
Issue number1
DOIs
Publication statusPublished - 3 May 2019

Keywords

  • Antacid
  • Cough
  • Gastroesophageal reflux disease
  • Idiopathic pulmonary fibrosis
  • Registry

Cite this

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. / Gastroesophageal reflux and antacid therapy in IPF : Analysis from the Australia IPF Registry. In: BMC Pulmonary Medicine. 2019 ; Vol. 19, No. 1.
@article{d8ab1b20470842f3a3faa6c0b299704c,
title = "Gastroesophageal reflux and antacid therapy in IPF: Analysis from the Australia IPF Registry",
abstract = "Background and objective: 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. Methods: 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. Results: 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. Conclusions: 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.",
keywords = "Antacid, Cough, Gastroesophageal reflux disease, Idiopathic pulmonary fibrosis, Registry",
author = "Jo, {Helen E.} and Corte, {Tamera J.} and Ian Glaspole and Christopher Grainge and Hopkins, {Peter M.A.} and Yuben Moodley and Reynolds, {Paul N.} and Sally Chapman and Walters, {E. Haydn} and Christopher Zappala and Heather Allan and Keir, {Gregory J.} and Cooper, {Wendy A.} and Mahar, {Annabelle M.} and Samantha Ellis and Sacha MacAnsh and Goh, {Nicole S.}",
year = "2019",
month = "5",
day = "3",
doi = "10.1186/s12890-019-0846-2",
language = "English",
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Jo, HE, Corte, TJ, Glaspole, I, Grainge, C, Hopkins, PMA, Moodley, Y, Reynolds, PN, Chapman, S, Walters, EH, Zappala, C, Allan, H, Keir, GJ, Cooper, WA, Mahar, AM, Ellis, S, MacAnsh, S & Goh, NS 2019, 'Gastroesophageal reflux and antacid therapy in IPF: Analysis from the Australia IPF Registry' BMC Pulmonary Medicine, vol. 19, no. 1, 84. https://doi.org/10.1186/s12890-019-0846-2

Gastroesophageal reflux and antacid therapy in IPF : Analysis from the Australia IPF Registry. / 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.

In: BMC Pulmonary Medicine, Vol. 19, No. 1, 84, 03.05.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Gastroesophageal reflux and antacid therapy in IPF

T2 - Analysis from the Australia IPF Registry

AU - Jo, Helen E.

AU - Corte, Tamera J.

AU - Glaspole, Ian

AU - Grainge, Christopher

AU - Hopkins, Peter M.A.

AU - Moodley, Yuben

AU - Reynolds, Paul N.

AU - Chapman, Sally

AU - Walters, E. Haydn

AU - Zappala, Christopher

AU - Allan, Heather

AU - Keir, Gregory J.

AU - Cooper, Wendy A.

AU - Mahar, Annabelle M.

AU - Ellis, Samantha

AU - MacAnsh, Sacha

AU - Goh, Nicole S.

PY - 2019/5/3

Y1 - 2019/5/3

N2 - Background and objective: 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. Methods: 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. Results: 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. Conclusions: 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.

AB - Background and objective: 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. Methods: 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. Results: 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. Conclusions: 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.

KW - Antacid

KW - Cough

KW - Gastroesophageal reflux disease

KW - Idiopathic pulmonary fibrosis

KW - Registry

UR - http://www.scopus.com/inward/record.url?scp=85065251156&partnerID=8YFLogxK

U2 - 10.1186/s12890-019-0846-2

DO - 10.1186/s12890-019-0846-2

M3 - Article

VL - 19

JO - BMC Pulmonary Medicine

JF - BMC Pulmonary Medicine

SN - 1471-2466

IS - 1

M1 - 84

ER -