Monocytes, Mortality, and Disease Progression in IPF: A time-to-event analysis

<bold>Introduction:</bold> There is evidence to suggest components of the full blood count (FBC) are associated with disease progression and mortality in patients with IPF. There is little data examining the average time to disease progression and death in patients with elevated baseline parameters. <bold>Methods:</bold> A retrospective review of electronic health records of patients diagnosed with IPF in a single tertiary centre in the UK between October 2008 and March 2018 was performed, recording baseline parameters of the FBC, time to disease progression, and death. Disease progression was defined as ≥10% absolute decline in forced vital capacity (FVC). <bold>Results:</bold> 249 patients (Mean [SD] age 72.7 [8.6], 69.9% Male [n=174]) were included. Patients with monocytes above the normal range (³0.8x109/L) had significantly shorter time to disease progression days [SE] (737 [82] vs 971 [79], p=0.42) and death (1175 [90] vs 1636 [87], p<0.001), this can be visualised in Figure 1. Cox proportional hazards regression analysis also demonstrated that elevated baseline monocytes predict mortality (HR= 1.77, 95% CI 1.10-2.86, p=0.19). There were no significant associations between any other element of the FBC and time to disease progression or death in our cohort. <bold>Conclusions:</bold> An elevated serum monocyte count at baseline predicts early progression and death in IPF patients. This may be used as a useful clinical tool to inform investigation and management strategies in IPF. <fig><object-id>erj;64/suppl_68/PA5162/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>