Clinical impact of weight loss on mortality in patients with idiopathic pulmonary fibrosis: a retrospective cohort study

Background: Patients with idiopathic pulmonary fibrosis (IPF) often experience weight loss during the follow-up period. However, the prevalence and clinical impact of weight loss in these patients still need to be elucidated. Methods This retrospective single-center study reviewed 134 consecutive patients diagnosed with IPF. Clinical data of patients were compared according to the significant weight loss. We analyzed whether the clinical impact of significant weight loss differed regarding the pirfenidone dose. Results The median follow-up period was 22.1 months. Of the 134 patients, 42 (31.3%) experienced significant weight loss. Significant weight loss was independently associated with mortality (hazard ratio [HR]; 2.650; 95% confidence interval [CI], 1.108–6.341; p  = 0.029) after adjusting for lung function and other significant risk factor (6-minute walk test distance: HR, 0.992; 95% CI, 0.992–0.987; p  = 0.003) in multivariate analysis. The median survival of patients with significant weight loss (n = 26) was shorter than that of those without significant weight loss (n = 50) in the reduced dose pirfenidone group (28.3 ± 3.1 vs 41.8 ± 3.1 months, p  = 0.013). Compared with patients without significant weight loss (n = 38), patients with significant weight loss (n = 15) also showed a marginally-significant shorter survival in the full-dose pirfenidone group (28.9 ± 3.1 vs 39.8 ± 2.6 months, p  = 0.085). Conclusions Significant weight loss is a prognostic factor in patients with IPF regardless of pirfenidone dose. Vigilant monitoring might be necessary to detect weight loss during the clinical course in these patients.