title: Gastroesophageal reflux therapy is associated with longer survival in patients with idiopathic pulmonary fibrosis.
abstract: BACKGROUND
  Gastroesophageal reflux (GER) is highly prevalent in patients with idiopathic pulmonary fibrosis (IPF). Chronic microaspiration secondary to GER may play a role in the pathogenesis and natural history of IPF.
  
  
  OBJECTIVE
  To investigate the relationship between GER-related variables and survival time in patients with IPF.
  
  
  METHODS
  Regression analysis was used to investigate the relationship between GER-related variables and survival time in a retrospectively identified cohort of patients with well-characterized IPF from two academic medical centers.
  
  
  RESULTS
  Two hundred four patients were identified for inclusion. GER-related variables were common in this cohort: reported symptoms of GER (34%), a history of GER disease (45%), reported use of GER medications (47%), and Nissen fundoplication (5%). These GER-related variables were significantly associated with longer survival time on unadjusted analysis. After adjustment, the use of GER medications was an independent predictor of longer survival time. In addition, the use of gastroesophageal reflux medications was associated with a lower radiologic fibrosis score. These findings were present regardless of center.
  
  
  CONCLUSIONS
  The reported use of GER medications is associated with decreased radiologic fibrosis and is an independent predictor of longer survival time in patients with IPF. These findings further support the hypothesis that GER and chronic microaspiration may play important roles in the pathobiology of IPF.
authors.affiliation: Department of Medicine, University of California San Francisco, USA. joyce.lee4@ucsf.edu
authors.forename: Joyce S
authors.initials: JS
authors.lastname: Lee
authors.forename: Jay H
authors.initials: JH
authors.lastname: Ryu
authors.forename: Brett M
authors.initials: BM
authors.lastname: Elicker
authors.forename: Carmen P
authors.initials: CP
authors.lastname: Lydell
authors.forename: Kirk D
authors.initials: KD
authors.lastname: Jones
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Wolters
authors.forename: Talmadge E
authors.initials: TE
authors.lastname: King
authors.forename: Harold R
authors.initials: HR
authors.lastname: Collard
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000628:therapy*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D016016:Proportional Hazards Models; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011859:Radiography; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors