Monocyte Count as a Prognostic Biomarker in Patients with Idiopathic Pulmonary Fibrosis.
Michael KreuterJoyce S LeeArgyrios TzouvelekisJustin M OldhamPhilip L MolyneauxDerek WeyckerMark AtwoodKlaus-Uwe KirchgaesslerToby M MaherPublished in: American journal of respiratory and critical care medicine (2021)
Rationale: There is an urgent need for simple, cost-effective prognostic biomarkers for idiopathic pulmonary fibrosis (IPF); biomarkers that show potential include monocyte count. Objectives: We used pooled data from pirfenidone and IFNγ-1b trials to explore the association between monocyte count and prognosis in patients with IPF. Methods: This retrospective pooled analysis included patients (active and placebo arms) from the following four phase III, randomized, placebo-controlled trials: ASCEND (NCT01366209), CAPACITY (NCT00287729 and NCT00287716), and INSPIRE (NCT00075998). Outcomes included IPF progression (≥10% absolute decline in FVC% predicted, ≥50 m decline in 6-minute-walk distance, or death), all-cause hospitalization, and all-cause mortality over 1 year. The relationship between monocyte count (defined as time-dependent) and outcomes was assessed using bivariate and multivariable models. Measurements and Main Results: This analysis included 2,067 patients stratified by monocyte count (at baseline: <0.60 × 109 cells/L [n = 1,609], 0.60 to <0.95 × 109 cells/L [n = 408], and ≥0.95 × 109 cells/L [n = 50]). In adjusted analyses, a higher proportion of patients with monocyte counts of 0.60 to <0.95 × 109 cells/L or ≥0.95 × 109 cells/L versus <0.60 × 109 cells/L experienced IPF progression (P = 0.016 and P = 0.002, respectively), all-cause hospitalization (P = 0.030 and P = 0.003, respectively), and all-cause mortality (P = 0.005 and P < 0.001, respectively) over 1 year. Change in monocyte count from baseline was not associated with any of the outcomes over 1 year and did not appear to be affected by study treatment. Conclusions: In patients with IPF, elevated monocyte count was associated with increased risks of IPF progression, hospitalization, and mortality. Monocyte count may provide a simple and inexpensive prognostic biomarker in IPF.
Keyphrases
- human health
- idiopathic pulmonary fibrosis
- risk assessment
- peripheral blood
- climate change
- induced apoptosis
- dendritic cells
- cell cycle arrest
- phase iii
- interstitial lung disease
- endothelial cells
- end stage renal disease
- clinical trial
- open label
- oxidative stress
- chronic kidney disease
- endoplasmic reticulum stress
- type diabetes
- randomized controlled trial
- newly diagnosed
- immune response
- cell death
- skeletal muscle
- cardiovascular disease
- systemic sclerosis
- squamous cell carcinoma
- adipose tissue
- risk factors
- big data
- patient reported
- rectal cancer
- data analysis