Low income and outcome in idiopathic pulmonary fibrosis: An association to uncover

Sesé, Lucile; Caliez, Julien; Annesi-Maesano, Isabella; Cottin, Vincent; Pesce, Giancarlo; Didier, Morgane; Carton, Zohra; Israel-Biet, Dominique; Crestani, Bruno; Guillot Dudoret, Stéphanie; Cadranel, Jacques; Wallaert, Benoit; Tazi, Abdellatif; Maître, Bernard; Prévot, Grégoire; Marchand-Adam, Sylvain; Hirschi, Sandrine; Dury, Sandra; Giraud, Violaine; Gondouin, Anne; Bonniaud, Philippe; Traclet, Julie; Juvin, Karine; Borie, Raphael; Bernaudin, Jean-François; Valeyre, Dominique; Cavalin, Catherine; Nunes, Hilario; COFI Collaborators, C.

Sesé, Lucile; Caliez, Julien; Annesi-Maesano, Isabella; Cottin, Vincent; Pesce, Giancarlo; Didier, Morgane; Carton, Zohra; Israel-Biet, Dominique; Crestani, Bruno; Guillot Dudoret, Stéphanie; Cadranel, Jacques; Wallaert, Benoit; Tazi, Abdellatif; Maître, Bernard; Prévot, Grégoire; Marchand-Adam, Sylvain; Hirschi, Sandrine; Dury, Sandra; Giraud, Violaine; Gondouin, Anne; Bonniaud, Philippe; Traclet, Julie; Juvin, Karine; Borie, Raphael; Bernaudin, Jean-François; Valeyre, Dominique; Cavalin, Catherine; Nunes, Hilario; COFI Collaborators, C. (2021), Low income and outcome in idiopathic pulmonary fibrosis: An association to uncover, Respiratory Medicine, 183, p. 106415. 10.1016/j.rmed.2021.106415

Type

Article accepté pour publication ou publié

Date

2021

Journal name

Respiratory Medicine

Volume

183

Publisher

Elsevier

Pages

106415

Publication identifier

10.1016/j.rmed.2021.106415

Metadata

Show full item record

Author(s)

Sesé, Lucile
Service de pneumologie [Avicenne]
Caliez, Julien
Annesi-Maesano, Isabella
Institut Desbrest de santé publique [IDESP]
Cottin, Vincent
CIC CHU Lyon (inserm)
Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL]
Pesce, Giancarlo
Institut Pierre Louis d'Epidémiologie et de Santé Publique [iPLESP]
Physiopathologie et Epidémiologie des Maladies Respiratoires [PHERE (UMR_S_1152 / U1152)]
Didier, Morgane
Centre de référence maladies rares des maladies pulmonaires rares de l’adulte (CHU Dijon) [CRMR des maladies pulmonaires rares de l’adulte]
Carton, Zohra
Service de pneumologie [Avicenne]
Israel-Biet, Dominique
Service de Pneumologie, soins intensifs [Pneumo - HEGP]
Crestani, Bruno
CIC - CHU Bichat
Service de Pneumologie A [Paris]
Guillot Dudoret, Stéphanie
Cadranel, Jacques
Centre de référence maladies rares des maladies pulmonaires rares de l’adulte (CHU Dijon) [CRMR des maladies pulmonaires rares de l’adulte]
Wallaert, Benoit
Hôpital Albert Calmette
Service de Pneumologie et Immuno-Allergologie [CHU LIlle]
Tazi, Abdellatif
Immunologie humaine, physiopathologie & immunothérapie [HIPI (UMR_S_976 / U976)]
Maître, Bernard
Service de physiologie, explorations fonctionnelles [Mondor]
Institut Mondor de Recherche Biomédicale [IMRB]
Prévot, Grégoire
Service de pneumologie [Toulouse]
Marchand-Adam, Sylvain
CHU Trousseau [Tours]
Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 [CEPR]
Hirschi, Sandrine
Dury, Sandra
Giraud, Violaine
Gondouin, Anne
Bonniaud, Philippe
Service des maladies respiratoires [CHU de Dijon]
Service de Pneumologie Soins Intensifs, Appareillage Respiratoire [CHU de Dijon]
Traclet, Julie
CIC CHU Lyon (inserm)
Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL]
Juvin, Karine
Borie, Raphael
CIC - CHU Bichat
Service de Pneumologie A [Paris]
Bernaudin, Jean-François
Service de pneumologie [Avicenne]
Valeyre, Dominique
Service de pneumologie [Avicenne]
Cavalin, Catherine
Institut de Recherche Interdisciplinaire en Sciences Sociales [IRISSO]
Nunes, Hilario
Service de pneumologie [Avicenne]
COFI Collaborators, C.

Abstract (EN)

BackgroundLow income, a known prognostic indicator of various chronic respiratory diseases, has not been properly studied in idiopathic pulmonary fibrosis (IPF). We hypothesize that a low income has an adverse prognostic impact on IPF.MethodsPatients were selected from the French national prospective cohort COFI. Patients’ income was assessed through the median city-level income provided by the French National Institute of Statistics and Economic Studies according to their residential address. Patients were classified in two groups as “low income” vs. “higher income” depending on whether their annual income was estimated to be < or ≥18 170 €/year (the first quartile of the income distribution in the study population). The survival and progression-free survival (PFS) of the groups were compared by a log-rank test and a Cox model in multivariate analysis.Results200 patients were included. The average follow-up was 33.8 ± 22.7 months. Patients in the low income group were significantly more likely to be of non-European origin (p < 0.006), and to have at least one occupational exposure (p < 0.0001), and they tended to have a higher cumulative exposure to fine particles PM2.5 (p = 0.057). After adjusting for age, gender, forced vital capacity at inclusion, geographical origin, and occupational exposure having a low-income level was a factor associated with a worse PFS (HR: 1.81; CI95%: 1.24–2.62, p = 0.001) and overall survival (HR: 1.49; CI95%: 1.0006–2.23, p = 0.049).ConclusionsLow income appears to be a prognostic factor in IPF. IPF patients with low incomes may also be exposed more frequently to occupational exposures.

Subjects / Keywords

Idiopathic pulmonary fibrosis; Socioeconomic status; Income; Air pollution; Occupational exposure