Background: The effect of antacids on prognosis of patients with idiopathic pulmonary fibrosis (IPF) is controversial. Current guideline recommends against using it to improve respiratory outcomes. We aimed to investigate the impact of antacids on overall survival of patients with IPF.
Methods: Clinical data of IPF patients were reviewed with common data model set-up at the institute. The overall survival was compared between patients treated with antacids (proton pump inhibitors, H2-blockers or potassium competitive acid blockers) for 8 weeks or more and who were not.
Results: From January 1998 to February 2019, a total of 2,327 patients with IPF were identified; the mean age was 66.8 years, 75.8% were male, and 468 (20.1%) patients died during the follow-up (median period: 44.8 months, interquartile range: 14.3?112.3 months). Among the patients, 1,068 (45.9%) were given antacids for 8 or more weeks. The Kaplan-Meier curve showed significantly better survival in the antacid group (median survival 5.9 vs. 21.0 months, Figure 1). In the multivariable Cox analysis adjusted for age, baseline forced vital capacity, diffusing capacity of the lungs for carbon monoxide and treatment for IPF, antacids therapy was independently associated with better survival (hazard ratio 0.66; 95% confidence interval 0.53-0.80; p < 0.001)
Conclusions: Our results suggest that antacids might be associated with favourable outcome in patients with IPF.