Evaluating the Progressive Factor's Impact on IPF Patients Treated with Antifibrotic Agents Over One Year

<bold>Background:</bold> Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressively worsening disease of unknown cause. The 2022 PPF concept isn't suited for IPF patients, and current antifibrotic treatments don't effectively track disease progression. This study aims to identify factors influencing disease progression in IPF patients after one year of antifibrotic treatment. <bold>Methods:</bold> In a prospective, observational cohort study, we enrolled 119 patients diagnosed with IPF between 2010 and 2022, all of whom received antifibrotic drugs approved by national health insurance. Progressive IPF was defined by worsening respiratory symptoms, decline in lung function, and HRCT imaging deterioration. Exclusions were made for deaths within a year (n=16) and incomplete follow-ups (n=14). <bold>Results:</bold> Of 89 IPF patients followed for 38.3 months on average, 55.1%(49/89) progressed after a year of antifibrotic treatment. There were no significant demographic differences between groups. Risk factors for disease progression included the presence of bilateral lung crackles (HR: 3.34, CI: 1.05-10.61, p=0.041) and defined UIP (HR: 2.77, CI: 1.16-6.614, p=0.022) at treatment initiation, and changes in FVC (%) (HR: 1.125, CI: 1.063-1.19, p<0.001) after one year. Multivariate Cox regression analysis identified FVC changes as independent predictors of disease progression. Furthermore, the group with progressive IPF showed a higher mortality rate (HR: 3.229, 95% CI: 1.144-9.113, p=0.027). <bold>Conclusions:</bold> About 55% of IPF patients show progression within one year despite antifibrotic treatment. Changes in FVC are predictive of IPF progression, and a higher mortality rate is associated with progressive IPF.