Skip to main content
Top
Published in:

Open Access 06-09-2024 | Idiopathic Pulmonary Fibrosis | BRIEF REPORT

Utility of the 52-Gene Risk Score to Identify Patients with Idiopathic Pulmonary Fibrosis at Greater Risk of Mortality in the Era of Antifibrotic Therapy

Authors: Julia F. Söllner, Stefan Bentink, Christian Hesslinger, Thomas B. Leonard, Megan L. Neely, Nina M. Patel, Thomas Schlange, Jamie L. Todd, Richard Vinisko, Margaret L. Salisbury, on behalf of the IPF-PRO Registry investigators

Published in: Lung | Issue 5/2024

Login to get access

Abstract

Purpose

We investigated whether a 52-gene signature was associated with transplant-free survival and other clinically meaningful outcomes in patients with idiopathic pulmonary fibrosis (IPF) in the IPF-PRO Registry, which enrolled patients who were and were not taking antifibrotic therapy.

Methods

The 52-gene risk signature was implemented to classify patients as being at “high risk” or “low risk” of disease progression and mortality. Transplant-free survival and other outcomes were compared between patients with a low-risk versus high-risk signature.

Results

The 52-gene signature classified 159 patients as at low risk and 86 as at high risk; in these groups, respectively, 56.6% and 51.2% used antifibrotic therapy at enrollment. Among those taking antifibrotic therapy, patients with a low-risk versus high-risk signature were at decreased risk of death, a composite of lung transplant or death, and a composite of decline in DLco % predicted > 15%, lung transplant, or death. Similar results were observed in the overall cohort.

Conclusions

These data suggest that the 52-gene signature can be used in patients with IPF treated with antifibrotic therapy to distinguish patients at higher risk of disease progression and mortality.
Appendix
Available only for authorised users
Literature
1.
go back to reference Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T et al (2022) Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 205:e18–e47CrossRefPubMedPubMedCentral Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T et al (2022) Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 205:e18–e47CrossRefPubMedPubMedCentral
2.
go back to reference Snyder L, Neely ML, Hellkamp AS, O’Brien E, de Andrade J, Conoscenti CS et al (2019) Predictors of death or lung transplant after a diagnosis of idiopathic pulmonary fibrosis: insights from the IPF-PRO Registry. Respir Res 20:105CrossRefPubMedPubMedCentral Snyder L, Neely ML, Hellkamp AS, O’Brien E, de Andrade J, Conoscenti CS et al (2019) Predictors of death or lung transplant after a diagnosis of idiopathic pulmonary fibrosis: insights from the IPF-PRO Registry. Respir Res 20:105CrossRefPubMedPubMedCentral
3.
go back to reference Behr J, Prasse A, Wirtz H, Koschel D, Pittrow D, Held M et al (2020) Survival and course of lung function in the presence or absence of antifibrotic treatment in patients with idiopathic pulmonary fibrosis: long-term results of the INSIGHTS-IPF registry. Eur Respir J 56:1902279CrossRefPubMed Behr J, Prasse A, Wirtz H, Koschel D, Pittrow D, Held M et al (2020) Survival and course of lung function in the presence or absence of antifibrotic treatment in patients with idiopathic pulmonary fibrosis: long-term results of the INSIGHTS-IPF registry. Eur Respir J 56:1902279CrossRefPubMed
4.
go back to reference Boon K, Bailey NW, Yang J, Steel MP, Groshong S, Kervitsky D, Brown KK, Schwarz MI, Schwartz DA (2009) Molecular phenotypes distinguish patients with relatively stable from progressive idiopathic pulmonary fibrosis (IPF). PLoS ONE 4:e5134CrossRefPubMedPubMedCentral Boon K, Bailey NW, Yang J, Steel MP, Groshong S, Kervitsky D, Brown KK, Schwarz MI, Schwartz DA (2009) Molecular phenotypes distinguish patients with relatively stable from progressive idiopathic pulmonary fibrosis (IPF). PLoS ONE 4:e5134CrossRefPubMedPubMedCentral
5.
go back to reference Huang Y, Oldham JM, Ma SF, Unterman A, Liao SY, Barros AJ et al (2021) Blood transcriptomics predicts progression of pulmonary fibrosis and associated natural killer cells. Am J Respir Crit Care Med 204:197–208CrossRefPubMedPubMedCentral Huang Y, Oldham JM, Ma SF, Unterman A, Liao SY, Barros AJ et al (2021) Blood transcriptomics predicts progression of pulmonary fibrosis and associated natural killer cells. Am J Respir Crit Care Med 204:197–208CrossRefPubMedPubMedCentral
6.
go back to reference Herazo-Maya JD, Noth I, Duncan SR, Kim S, Ma SF, Tseng GC et al (2013) Peripheral blood mononuclear cell gene expression profiles predict poor outcome in idiopathic pulmonary fibrosis. Sci Transl Med 5:205ra136CrossRefPubMedPubMedCentral Herazo-Maya JD, Noth I, Duncan SR, Kim S, Ma SF, Tseng GC et al (2013) Peripheral blood mononuclear cell gene expression profiles predict poor outcome in idiopathic pulmonary fibrosis. Sci Transl Med 5:205ra136CrossRefPubMedPubMedCentral
7.
go back to reference Casanova NG, Zhou T, Gonzalez-Garay ML, Lussier YA, Sweiss N, Ma SF, Noth I, Knox KS, Garcia JGN (2021) MicroRNA and protein-coding gene expression analysis in idiopathic pulmonary fibrosis yields novel biomarker signatures associated to survival. Transl Res 228:1–12CrossRefPubMed Casanova NG, Zhou T, Gonzalez-Garay ML, Lussier YA, Sweiss N, Ma SF, Noth I, Knox KS, Garcia JGN (2021) MicroRNA and protein-coding gene expression analysis in idiopathic pulmonary fibrosis yields novel biomarker signatures associated to survival. Transl Res 228:1–12CrossRefPubMed
8.
go back to reference Ruan P, Todd JL, Zhao H, Liu Y, Vinisko R, Soellner JF et al (2023) (2023) Integrative multi-omics analysis reveals novel idiopathic pulmonary fibrosis endotypes associated with disease progression. Respir Res 24:141CrossRefPubMedPubMedCentral Ruan P, Todd JL, Zhao H, Liu Y, Vinisko R, Soellner JF et al (2023) (2023) Integrative multi-omics analysis reveals novel idiopathic pulmonary fibrosis endotypes associated with disease progression. Respir Res 24:141CrossRefPubMedPubMedCentral
9.
go back to reference Herazo-Maya JD, Sun J, Molyneaux PL, Li Q, Villalba JA, Tzouvelekis A et al (2017) Validation of a 52-gene risk profile for outcome prediction in patients with idiopathic pulmonary fibrosis: an international, multicentre, cohort study. Lancet Respir Med 5:857–868CrossRefPubMedPubMedCentral Herazo-Maya JD, Sun J, Molyneaux PL, Li Q, Villalba JA, Tzouvelekis A et al (2017) Validation of a 52-gene risk profile for outcome prediction in patients with idiopathic pulmonary fibrosis: an international, multicentre, cohort study. Lancet Respir Med 5:857–868CrossRefPubMedPubMedCentral
10.
go back to reference King TE Jr, Bradford WZ, Castro-Bernardini S, Fagan EA, Glaspole I, Glassberg MK et al (2014) A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N Engl J Med 370:2083–2092CrossRefPubMed King TE Jr, Bradford WZ, Castro-Bernardini S, Fagan EA, Glaspole I, Glassberg MK et al (2014) A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N Engl J Med 370:2083–2092CrossRefPubMed
11.
go back to reference Richeldi L, du Bois RM, Raghu G, Azuma A, Brown KK, Costabel U et al (2014) Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med 370:2071–2082CrossRefPubMed Richeldi L, du Bois RM, Raghu G, Azuma A, Brown KK, Costabel U et al (2014) Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med 370:2071–2082CrossRefPubMed
12.
go back to reference Kang J, Han M, Song JW (2020) Antifibrotic treatment improves clinical outcomes in patients with idiopathic pulmonary fibrosis: a propensity score matching analysis. Sci Rep 10:15620CrossRefPubMedPubMedCentral Kang J, Han M, Song JW (2020) Antifibrotic treatment improves clinical outcomes in patients with idiopathic pulmonary fibrosis: a propensity score matching analysis. Sci Rep 10:15620CrossRefPubMedPubMedCentral
13.
go back to reference de Andrade JA, Neely ML, Hellkamp AS, Culver DA, Kim HJ, Liesching T et al (2023) Effect of antifibrotic therapy on survival in patients with idiopathic pulmonary fibrosis. Clin Ther 45:306–315CrossRefPubMed de Andrade JA, Neely ML, Hellkamp AS, Culver DA, Kim HJ, Liesching T et al (2023) Effect of antifibrotic therapy on survival in patients with idiopathic pulmonary fibrosis. Clin Ther 45:306–315CrossRefPubMed
14.
go back to reference O’Brien EC, Durheim MT, Gamerman V, Garfinkel S, Anstrom KJ, Palmer SM, Conoscenti CS (2016) Rationale for and design of the idiopathic pulmonary fibrosis-PRospective outcomes (IPF-PRO) registry. BMJ Open Respir Res 3:e000108CrossRefPubMedPubMedCentral O’Brien EC, Durheim MT, Gamerman V, Garfinkel S, Anstrom KJ, Palmer SM, Conoscenti CS (2016) Rationale for and design of the idiopathic pulmonary fibrosis-PRospective outcomes (IPF-PRO) registry. BMJ Open Respir Res 3:e000108CrossRefPubMedPubMedCentral
15.
go back to reference Collard HR, Bradford WZ, Cottin V, Flaherty KR, King TE Jr, Koch GG (2015) A new era in idiopathic pulmonary fibrosis: considerations for future clinical trials. Eur Respir J 46:243–249CrossRefPubMed Collard HR, Bradford WZ, Cottin V, Flaherty KR, King TE Jr, Koch GG (2015) A new era in idiopathic pulmonary fibrosis: considerations for future clinical trials. Eur Respir J 46:243–249CrossRefPubMed
16.
go back to reference Nathan SD, Martinez FJ (2017) Pitfalls in developing new compounds for idiopathic pulmonary fibrosis. Curr Opin Pulm Med 23:426–431CrossRefPubMed Nathan SD, Martinez FJ (2017) Pitfalls in developing new compounds for idiopathic pulmonary fibrosis. Curr Opin Pulm Med 23:426–431CrossRefPubMed
17.
Metadata
Title
Utility of the 52-Gene Risk Score to Identify Patients with Idiopathic Pulmonary Fibrosis at Greater Risk of Mortality in the Era of Antifibrotic Therapy
Authors
Julia F. Söllner
Stefan Bentink
Christian Hesslinger
Thomas B. Leonard
Megan L. Neely
Nina M. Patel
Thomas Schlange
Jamie L. Todd
Richard Vinisko
Margaret L. Salisbury
on behalf of the IPF-PRO Registry investigators
Publication date
06-09-2024
Publisher
Springer US
Published in
Lung / Issue 5/2024
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-024-00742-x

Other articles of this Issue 5/2024

Lung 5/2024 Go to the issue

A quick guide to ECGs

Improve your ECG interpretation skills with this comprehensive, rapid, interactive course. Expert advice provides detailed feedback as you work through 50 ECGs covering the most common cardiac presentations to ensure your practice stays up to date. 

PD Dr. Carsten W. Israel
Developed by: Springer Medizin
Start the cases

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Read more