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Revue des Maladies Respiratoires

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Gender differences in idiopathic pulmonary fibrosis: Are men and women equal or not? - 09/06/21

Différences entre les sexes dans la fibrose pulmonaire idiopathique: les hommes et les femmes sont-ils égaux?

Doi : 10.1016/j.rmr.2021.02.045 
L. Sese 1, ⁎ , H. Nunes 2, V. Cottin 3, D. Israel-Biet 4, B. Crestani 5, S. Guillot Dudoret 6, J. Cadranel 7, B. Wallaert 8, A. Tazi 9, B. Maître 10, G. Prévot 11, S. Marchand-Adam 12, S. Hirschi 13, S. Dury 14, V. Giraud 15, A. Gondouin 16, P. Bonniaud 17, J. Traclet 3, K. Juvin 4, R. Borie 5, Z. Carton 2, J. Caliez 2, O. Freynet 2, T. Gille 1, C. Planes 1, D. Valeyre 2, Y. Uzunhan 2
1 Assistance Publique–Hôpitaux de Paris (AP–HP), Service de Physiologie, Hôpital Avicenne, Bobigny, France 
2 Assistance Publique–Hôpitaux de Paris (AP–HP), Service de Pneumologie, Hôpital Avicenne, Bobigny, France 
3 Service de Pneumologie, Hôpital Louis Pradel, Lyon, France 
4 AP–HP, Service de Pneumologie, Hôpital HEGP, Paris, France 
5 AP–HP, Service de Pneumologie, Hôpital Bichat, Paris, France 
6 Service de Pneumologie, Hôpital Pontchaillou, Rennes, France 
7 AP–HP, Service de Pneumologie, Hôpital Tenon, Paris, France 
8 Service de Pneumologie, Hôpital Albert Calmette, Lille, France 
9 AP–HP, Service de Pneumologie, Hôpital Saint-Louis, Paris, France 
10 AP–HP, Service de Pneumologie, Hôpital Henri-Mondor, Créteil, France 
11 Service de Pneumologie, Hôpital Larrey, Toulouse, France 
12 Service de Pneumologie, Hôpital Bretonneau, Tours, France 
13 Service de Pneumologie, Nouvel Hôpital Civil, Strasbourg, France 
14 Service de Pneumologie, Hôpital Maison Blanche, Reims, France 
15 AP–HP, Service de Pneumologie, Hôpital Ambroise Paré, Boulogne, France 
16 Service de Pneumologie, Hôpital Jean Minjoz, Besançon, France 
17 Service de Pneumologie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France 

⁎Corresponding author.
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Résumé

Background

Few studies analyzed gender-related outcomes and characteristics differences of patients with idiopathic pulmonary fibrosis (IPF). The aim of the study was to explore gender differences in a French IPF cohort.

Methods

236 patients with incident IPF were included in the multicentric longitudinal prospective cohort COhorte FIbrose (COFI), and followed for 5 years. Men and women were compared for characteristics atinclusion (t-test, Chi2 or ANOVA) and survival (Log rank, Cox model).

Results

The population consisted of 51 (22%) women and 185(78%) men. At inclusion women significantly differed from men for an older age (>65 years, 78 vs. 61%, P=0.028), a lower proportion of smokers (P<0.001) and lower frequency of occupational exposure (P=0.012). At baseline forced vital capacity (FVC) was significantly better in women (83±25 vs. 75±19%, P=0.046); honeycombing (78.4 vs. 90.3%, P=0.041) and emphysema (11.8 vs. 25.9%, P=0.029) on CT scan were less common in women. Comorbidities such as osteoporosis (9.8 vs. 2.2%, P=0.025) and thromboembolic events (11.8 vs. 2.2%, P=0.008) were more frequently reported among women. Women were less likely to be transplanted (2 vs. 11%, P=0.039). Survival median was comparable between men and women (31months vs. 40 months, P=0.2). After adjusting for age and FVC at inclusion, being a woman was not associated to a better survival.

Conclusions

At diagnosis women appear to have a distinct imaging pattern and a better FVC, which may be due to less exposure history compared to men. However, outcomes remain comparable in both sexes. Less access to lung transplantation in women may be due to age and comorbidities.

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Keywords : Idiopathic pulmonary fibrosis, Occupation, Comorbidities, Gender, Women, Transplantation


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© 2021  Publié par Elsevier Masson SAS.
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Vol 38 - N° 6

P. 589-590 - juin 2021 Retour au numéro
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