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Interferon-1b Therapy in Idiopathic Pulmonary Fibrosis^*

A Metaanalysis

^* From the Division of Pulmonary and Critical Care Medicine (Drs. Bajwa and Malhotra), Brigham and Women’s Hospital, Boston MA; the Department of Medicine (Drs. Ayas and Schulzer) and the Pacific Parkinson’s Research Centre (Mr. Mak), University of British Columbia, Vancouver, BC, Canada; and the Division of Pulmonary and Critical Care Medicine (Dr. Ryu), Mayo Clinic, Rochester, MN.

Correspondence to: Atul Malhotra, MD, FCCP, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115; e-mail: amalhotra1{at}partners.org

Context: Despite the investigation of multiple therapeutic options, idiopathic pulmonary fibrosis (IPF) remains a devastating, progressively fatal disease. Much interest has focused on the use of interferon (IFN)-1b therapy, but the efficacy of this treatment has not been proven.

Objective: To determine whether IFN treatment reduces mortality in patients with IPF.

Design: A metaanalysis of randomized controlled trials evaluating the use of IFN-1b as treatment for IPF.

Main outcome measure: Mortality in patients treated with IFN-1b was compared to mortality in patients treated with control therapies.

Results: A total of three studies involving 390 patients was included in the analysis. IFN-1b therapy was associated with reduced mortality (hazard ratio [HR], 0.418; 95% confidence interval [CI], 0.253 to 0.690; p = 0.0003). A comparison of mortality at different time points revealed that IFN-1b therapy was associated with significantly reduced mortality at 1 year (0.0861; 95% CI, 0.0244 to 0.1478; p = 0.0063), 18 months (0.1682; 95% CI, 0.1065 to 0.2299; p < 0.0001), 650 days (0.1939; 95% CI, 0.1386 to 0.2492; p < 0.0001), and 2 years (0.2652; 95% CI, 0.1652 to 0.3652; p < 0.0001).

Conclusion: When the results of multiple studies are combined in a metaanalysis, IFN-1b therapy is associated with reduced mortality.

Key Words: interferon • lung • pulmonary fibrosis • restriction • survival • treatment

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