Abstract 1148P
Background
Statin use was associated with reduced all-cause mortality in interstitial lung disease and idiopathic pulmonary fibrosis (IPF) patients. To further investigate the potential preventive effects of statins on lung cancer development in IPF patients, we used clinical data warehouse (CDW) for electronic medical record (EMR)-based clinical research.
Methods
We retrospectively reviewed the EMR and CDW of 3,478 IPF patients in Catholic Medical Center from 2009 to 2018. We excluded 205 cases whose the age of initial diagnosis of IPF was over 80 years old or less than 40 years old, 88 cases diagnosed with lung cancer before IPF diagnosis and 293 cases who died before lung cancer diagnosis.
Results
We finally analyzed 2,892 IPF patients. We identified that there were 126 (4.35%) patients with lung cancer in IPF patients. Cumulative incidence of lung cancer development was higher in IPF patients not taking statin than those taking statin (P<0.001). The proportion of male (85.7% vs. 66.4%, P<0.001), that of patients taking statins for more than 30 days after IPF diagnosis (38.1% vs. 21.7%, P<0.001), that of current (22.2% vs. 9.3%, P<0.001) and ex-smokers (34.1% vs. 11.1%, P<0.001) was higher in IPF patients with lung cancer development. In cox-proportional hazard model, taking statin more than 30 days after IPF diagnosis (HR 0.58, 95% CI 0.37-0.92, P<0.05), male (HR 2.20, 95% CI 1.29-3.76, P < 0.01), ex-smoker (HR 2.46, 95% CI 1.58-3.83, P<0.001) and current smoker (HR 2.33, 95% CI 1.2-3.83, P<0.001) were associated with lung cancer development in IPF patients. After lung cancer diagnosis, statin use after IPF diagnosis was associated with longer overall survival (327.8 vs. 114.2 days, P=0.02). In cox-proportional hazard model, taking statin more than 30 days (HR 0.58, 95% CI 0.36-0.94, P<0.05) and male (HR 0.47, 9% CI 0.23-0.95, P<0.05) were associated with lung cancer mortality in IPF patients.
Conclusions
Taking statin more than 30 days after IPF diagnosis had preventive effect on lung cancer development. After lung cancer diagnosis, statin use was associated with lowering lung cancer mortality in IPF patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.