PPI Use Not Associated With Improved Survival in Idiopathic Pulmonary Fibrosis

Sarfaroj Khan 


September 08, 2020


  • In patients with idiopathic pulmonary fibrosis (IPF), the use of proton pump inhibitors (PPIs) is not associated with improved survival and reduced incidence of respiratory-related hospitalisation compared with non-use.

Why this matters

  • Findings suggest that PPIs may not be as beneficial in treating IPF as suggested by some studies and conditionally recommended in treatment guidelines.

Study design

  • This population-based cohort study included 3036 patients diagnosed with IPF between 2002 and 2016 using data from the UK Clinical Practice Research Datalink (CPRD).

  • 1852 PPI users were matched with 1852 non-users using propensity score matching.

  • Primary outcome: all-cause mortality; secondary outcomes: respiratory-related mortality and hospitalisations.

  • Funding: Canadian Institutes of Health Research and Canadian Foundation for Innovation.

Key results

  • Overall, 1703 deaths were reported from any cause (incidence rate, 26.7 per 100 per year; 95% CI, 25.5-28.0); 1125 (66%) deaths were related to respiratory diseases.

  • Median survival was 2.8 years (range, 0-13 years), and 70% of the patients died within 5 years of IPF diagnosis.

  • The adjusted HR of all-cause mortality with PPI use vs no use was 1.07 (95% CI, 0.94-1.22).

  • The adjusted HR of respiratory-related mortality and hospitalisations was 1.10 (95% CI, 0.94-1.28) and 1.00 (95% CI, 0.86-1.16), respectively.


  • Possibility of misclassification of IPF.

  • Lack of data on disease severity or laboratory tests related to pulmonary function.


Tran T, Assayag D, Ernst P, Suissa S. Effectiveness of proton pump inhibitors in idiopathic pulmonary fibrosis: a population-based cohort study. Chest. 2020 Aug 31 [Epub ahead of print]. doi: 10.1016/j.chest.2020.08.2080. PMID: 32882251 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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