P147 The changing shape of patients with idiopathic pulmonary fibrosis

Background Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible and ultimately fatal disease. An association between diabetes, obesity and IPF has previously been demonstrated. 1 Decreasing body mass index (BMI) is predictive of worse survival in Japanese cohorts. 2 Objective To investigate the metabolic characteristics in our cohort of IPF patients (South West Peninsula, England) receiving anti-fibrotic therapy (nintedanib or pirfenidone), observe how BMI changes over time and relationships with changes in forced vital capacity (FVC) and survival. Method Data was collected from IPF patients at the Regional Exeter ILD Centre at diagnosis (age, gender, FVC, BMI, co-morbidities) and subsequent appointments (FVC and BMI). Change between BMI/FVC at diagnosis and most recent BMI/FVC were calculated and standardised to time elapsed between data points (DBMI or DFVC respectively). National data were from Public Health England (2014 datasets). Results We reviewed 90 patients receiving antifibrotics. 76 were male (84%), mean age was 74. Their co-morbidities are illustrated by Table 1. Type 2 diabetes mellitus affected 14 patients (16%), compared with 12% in the age-adjusted general population. Recent BMIs were available for 46 patients. 10 patients (20%) had a normal BMI 18.5–24.99 (compared with a national average of 37%). Mean BMI (28.3) was significantly increased above the national average (27.3; p Conclusions A large proportion of our IPF cohort were classified as obese. Diabetes was a common comorbidity, and higher than the national average. Over time, most patients demonstrated a reduction in their BMI. In contrast to East Asian data, this reduction in BMI did not correlate with reduction in FVC or survival. References Kim YJ, Park J-W, Kyung Y, et al. Association of diabetes mellitus and metabolic syndrome with idiopathic pulmonary fibrosis. Tuberc Respir Dis 2009;67:113–120. Kishaba T, Nagano H, Nei Y, et al. Body mass index—percent forced vital capacity—respiratory hospitalisation: New staging for idiopathic pulmonary fibrosis patients. J Thorac Dis2016;8(12):3596–3604.