Daijiworld Media Network – New Delhi

New Delhi, Jan 24: A new large-scale real-world study has found that the use of angiotensin-converting enzyme (ACE) inhibitors may be associated with improved survival in patients with idiopathic pulmonary fibrosis (IPF), a chronic and progressive lung disease, though no similar benefit was seen in patients with chronic obstructive pulmonary disease (COPD).

ACE inhibitors are commonly prescribed for hypertension and cardiovascular disease, and earlier laboratory research had suggested they may have antifibrotic effects. To assess whether this potential benefit translates into real-world outcomes, researchers analysed mortality data among patients with IPF and compared it with matched COPD patients.

The retrospective study used linked electronic health records and national outcomes data from the Clinical Practice Research Datalink GP Online Database, combined with Hospital Episode Statistics and death registration records. ACE inhibitor use was defined as having received at least three prescriptions in the five years prior to diagnosis.

A total of 3,579 patients with idiopathic pulmonary fibrosis were included and matched with COPD control participants based on age, sex and smoking history. The average age of participants was 74 years, and 36 per cent were women. Researchers used multivariable Cox regression models to adjust for key factors such as body mass index, smoking status, socioeconomic deprivation, diabetes, chronic kidney disease and cardiovascular conditions. Competing risk analysis was also applied to account for cause-specific mortality in IPF patients.

The findings showed that ACE inhibitor use was more common among IPF patients than those with COPD. After adjusting for confounding factors, ACE inhibitor use was associated with a significantly lower risk of all-cause mortality in patients with idiopathic pulmonary fibrosis. However, no survival benefit linked to ACE inhibitor use was observed in the COPD group.

Researchers noted that the results suggest ACE inhibitors may offer a survival advantage for patients with IPF in routine clinical settings, independent of other health conditions. They cautioned, however, that further prospective clinical trials are needed to determine whether the association reflects a direct causal benefit of ACE inhibitor therapy in idiopathic pulmonary fibrosis.