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Eur Respir Rev. 2019 Oct 1;28(153). pii: 190044. doi: 10.1183/16000617.0044-2019. Print 2019 Sep 30.

Comorbidities in idiopathic pulmonary fibrosis: an underestimated issue.

Author information

1
UO di Pneumologia e Terapia Semi-Intensiva Respiratoria - Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe - MultiMedica IRCCS, Milan, Italy.
2
UO di Medicina Generale, Ospedale San Giuseppe - MultiMedica IRCCS, Milan, Italy chiara.lonati@multimedica.it.
3
Dipartimento di Oncologia ed Onco-ematologia, Università degli Studi di Milano, Milan, Italy.
4
Servizio Interaziendale di Anatomia Patologica, Polo Scientifico e Tecnologico, MultiMedica IRCCS, Milan, Italy.
5
Dipartimento di Diagnostica per Immagini e UO di Radiologia, MultiMedica IRCCS, Milan, Italy.
6
Dipartimento Universitario DIMES, Università di Bologna, Bologna, Italy.
7
UO di Medicina Generale, Ospedale San Giuseppe - MultiMedica IRCCS, Milan, Italy.

Abstract

Idiopathic pulmonary fibrosis (IPF) is a progressive and fibrosing lung disease with a poor prognosis. Between 60% and 70% of IPF patients die of IPF; the remaining causes of death may be due to comorbidities occurring in this ageing population. Interest in the role played by comorbidities in IPF has increased in the past few years. The optimal clinical management of IPF is multifaceted and not only involves antifibrotic treatment, but also vaccinations, oxygen supplementation, evaluation of nutritional status as well as psychological support and patient education. Symptom management, pulmonary rehabilitation, palliative care and treatment of comorbidities represent further areas of clinical intervention. This review analyses the major comorbidities observed in IPF, focusing on those that have the greatest impact on mortality and quality of life (QoL). The identification and treatment of comorbidities may help to improve patients' health-related QoL (i.e. sleep apnoea and depression), while some comorbidities (i.e. lung cancer, cardiovascular diseases and pulmonary hypertension) influence survival. It has been outlined that gathering comorbidities data improves the prediction of survival beyond the clinical and physiological parameters of IPF.

PMID:
31578211
DOI:
10.1183/16000617.0044-2019
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Conflict of interest statement

Conflict of interest: A. Caminati reports personal fees from Roche and Boehringer Ingelheim, outside the submitted work. Conflict of interest: C. Lonati has nothing to disclose. Conflict of interest: R. Cassandro has nothing to disclose. Conflict of interest: D. Elia has nothing to disclose. Conflict of interest: G. Pelosi has nothing to disclose. Conflict of interest: O. Torre has nothing to disclose. Conflict of interest: M. Zompatori has nothing to disclose. Conflict of interest: E. Uslenghi has nothing to disclose. Conflict of interest: S. Harari reports grants and personal fees from Roche, Actelion and Boehringer Ingelheim, outside the submitted work.

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