Geriatric nutritional risk index in antifibrotic therapy can predict tolerability and mortality risk

No prospective studies have investigated the relationship between nutritional status, tolerability to antifibrotic therapy, and mortality in patients with fibrotic interstitial lung diseases (ILDs). This prospective longitudinal study enrolled 290 consecutive patients with fibrotic ILDs who initiated antifibrotic therapy, including 164 with idiopathic pulmonary fibrosis (IPF) and 126 with non-IPF. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Overall, 106 patients (36.6%) were classified as having malnutrition-related risk (GNRI < 98) at baseline. The prevalence of malnutrition-related risk was comparable between patients with IPF and non-IPF, although it tended to be higher in the non-IPF group than in the IPF group. Patients with malnutrition-related risk showed higher cumulative incidence of antifibrotic therapy discontinuation. Importantly, in both IPF and non-IPF groups, the mortality risk was significantly higher in patients with malnutrition-related risk than in those without. Longitudinally, a lower GNRI at 1 year was associated with shorter survival. In multivariable analyses, baseline malnutrition-related risk was independently associated with increased risk of therapy discontinuation and mortality, even after adjusting for the ILD-gender-age-physiology index. These findings indicate that assessment of nutritional status helps predict antifibrotic therapy tolerability and mortality risk in patients with fibrotic ILD.

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Journal
Scientific Reports
Published
2026-04-01
DOI
https://doi.org/10.1038/s41598-026-45792-8
Primary Topic
Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
Type
article
Field-Weighted Citation Impact
0.00

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article

Geriatric nutritional risk index in antifibrotic therapy can predict tolerability and mortality risk

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Scientific Reports
Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
article

Geriatric nutritional risk index in antifibrotic therapy can predict tolerability and mortality risk

Hironao Hozumi, Koshi Yokomura, Naoki Inui, Sayomi Matsushima, Mikio Toyoshima, Kazuhiro Asada, Masanori Harada, Takuya Masuda, Masato Karayama, Miho Kanai, Noriyuki Enomoto, Keigo Koda, Yasutaka Mochizuka, Hideki Yasui, Toshihiro Masuda, Kazuki Tanaka, Dai Hashimoto, Mitsuru Niwa, Shinpei Kato, Takafumi Suda, Tomoyuki Fujisawa, Masaki Ikeda, Kosuke Suzuki, Masato Kono, Yusuke Inoue, Yusuke Kaida, Yuzo Suzuki, Hiroyuki Matsuda, Kazuki Furuhashi
article en

Abstract

No prospective studies have investigated the relationship between nutritional status, tolerability to antifibrotic therapy, and mortality in patients with fibrotic interstitial lung diseases (ILDs). This prospective longitudinal study enrolled 290 consecutive patients with fibrotic ILDs who initiated antifibrotic therapy, including 164 with idiopathic pulmonary fibrosis (IPF) and 126 with non-IPF. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Overall, 106 patients (36.6%) were classified as having malnutrition-related risk (GNRI < 98) at baseline. The prevalence of malnutrition-related risk was comparable between patients with IPF and non-IPF, although it tended to be higher in the non-IPF group than in the IPF group. Patients with malnutrition-related risk showed higher cumulative incidence of antifibrotic therapy discontinuation. Importantly, in both IPF and non-IPF groups, the mortality risk was significantly higher in patients with malnutrition-related risk than in those without. Longitudinally, a lower GNRI at 1 year was associated with shorter survival. In multivariable analyses, baseline malnutrition-related risk was independently associated with increased risk of therapy discontinuation and mortality, even after adjusting for the ILD-gender-age-physiology index. These findings indicate that assessment of nutritional status helps predict antifibrotic therapy tolerability and mortality risk in patients with fibrotic ILD.

Scientific Reports
Hamamatsu University (JP), Hamamatsu University School of Medicine (JP), Seirei Mikatabara General Hospital (JP), Iwata City Hospital (JP), Shizuoka Saiseikai General Hospital (JP), Hamamatsu Rosai Hospital (JP), Seirei Hamamatsu General Hospital (JP), Shizuoka City Hospital (JP), Shizuoka General Hospital (JP), Shizuoka Red Cross Hospital (JP), Fujieda Municipal General Hospital (JP), National Hospital Organization (JP), JA Shizuoka Koseiren ENSHU hospital (JP), Hamamatsu Medical Center (JP)
Japan Society for the Promotion of Science
Zero hunger
Openalex Percentile: Top 11%
Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
DOIOpen Access PDFOpenAlex
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