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Oxygen Therapy Use in Patients With Fibrotic Interstitial Lung Disease

Assessment of the Oxygen Use and Future Outcomes Associated With Oxygen Use in Patient With Fibrotic ILD

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT05957198
Enrollment
114921
Registered
2023-07-24
Start date
2023-07-25
Completion date
2023-09-26
Last updated
2024-11-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Lung Diseases, Interstitial

Brief summary

The purpose of this study is to describe initiation and use of oxygen therapy among patients with fibrotic Interstitial Lung Disease (ILD) and to assess the impact of oxygen therapy on clinical outcomes among patients with fibrotic ILD.

Interventions

None listed

Sponsors

Boehringer Ingelheim
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
RETROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* ≥2 fibrosing Interstitial Lung Disease (ILD) diagnoses in any position on different dates of service, within 365 days of each other, and in the same continuous enrollment period during the patient identification period. The fibrosing ILD diagnosis date will be defined as the date of the first fibrosing ILD diagnosis. The two fibrosing ILD diagnosis codes can be one of the following combinations: * 2 fibrosis codes * 1 fibrosis code & 1 ILD code that requires fibrosis code * ≥18 years of age as of the fibrosing ILD diagnosis date * Continuous enrollment with medical and pharmacy coverage for 12 months prior to the fibrosing ILD diagnosis date (pre-ILD baseline period)

Exclusion criteria

* Fibrosing ILD diagnosis in the 12-month pre-ILD baseline period * Unknown gender, geographic region, or insurance type

Design outcomes

Primary

MeasureTime frameDescription
Time to All-cause MortalityUp to 2099 days (from 01 October 2016 through 30 June 2022 (patient identification period)).Time to all-cause mortality is calculated as time between index date and mortality date. The oxygen therapy cohort index date was defined as the first date of a claim for oxygen therapy. The no oxygen therapy cohort index date was assigned as a date that was eligible to set an index date.
Sustained Oxygen Therapy Use Within the First 12 Months of Follow-upUp to month 12 of follow-up, in patient identification period from 01 October 2016 through 30 June 2022.The number of participants with ≥ 11 claims for oxygen therapy within 12 months of initiating oxygen therapy is reported. Using claims, sustained oxygen therapy use was defined among patients with at least 12 months of follow-up after the index date (oxygen initiation date), as a binary variable for the presence of ≥11 claims for oxygen therapy in a 12-month period.
Time to Sustained Oxygen Therapy UseUp to 2099 days (from 01 October 2016 through 30 June 2022 (patient identification period)).Time between the fibrosing ILD diagnosis date and the earliest date that defined the sustained oxygen therapy use is reported. Sustained oxygen therapy was defined as ≥ 11 claims for oxygen therapy within 12 months of initiating oxygen therapy.
Number of Participants With Disease Progression From Pre-index Forced Vital Capacity (FVC) Result to Index DateUp to 12 months prior to the index date (between 01 October 2016 through 30 June 2022 (patient identification period)).The Number of participants with disease progression is reported instead of time to disease progression in the Outcome Measure Data Table. Disease progression was defined as a 10% relative change between the forced vital capacity (FVC) pre-index value and the index date.
Number of Participants With Disease Progression From Index Date to Follow-up Forced Vital Capacity (FVC) ResultUp to month 12 of follow-up, in patient identification period from 01 October 2016 through 30 June 2022.The Number of participants with disease progression is reported instead of time to disease progression in the Outcome Measure Data Table. Disease progression was defined as a 10% relative change between the index date to follow-up FVC result.
Time to Oxygen Therapy InitiationUp to 2099 days (from 01 October 2016 through 30 June 2022 (patient identification period)).Time from the fibrosing Interstitial Lung Disease (ILD) diagnosis date to oxygen therapy initiation is reported. Descriptive statistics are rounded to one decimal place.

Secondary

MeasureTime frameDescription
Percentage of Participants With Hypoxemia in the Pre-Interstitial Lung Disease (ILD) Baseline PeriodUp to 12 months prior to the fibrosing ILD diagnosis date (between 01 October 2016 through 30 June 2022 (patient identification period)).Percentage of participants with hypoxemia in the pre-ILD baseline period. The Percentage of participants is reported instead of time to hypoxemia in the Outcome Measure Data Table. The pre-ILD baseline period is defined as 12 months prior to the fibrosing ILD diagnosis date.
Percentage of Participants With Acute Exacerbations Within the First 12 Month of the Follow up PeriodUp to 12 months post index date (between 01 October 2016 through 30 June 2022 (patient identification period)).Percentage of participants with acute exacerbations within the first 12 month of the follow up period. The Percentage of participants is reported instead of time to acute exacerbations in the Outcome Measure Data Table. The follow up period (variable period) started on the index date until the earliest of the following: disenrollment from the health plan, death, or the end of the study period.
Percentage of Participants With Acute Exacerbations in the Pre-index Baseline PeriodUp to 12 months prior to the index date (between 01 October 2016 through 30 June 2022 (patient identification period)).Percentage of participants with acute exacerbations in the pre-index baseline period. The Percentage of participants is reported instead of time to acute exacerbations in the Outcome Measure Data Table. The pre-index period was defined as the 12-month period prior to the index date. The index date is the first day of follow-up observation time for Aim 2.
Percentage of Participants With Hypoxemia in the Pre-index Baseline PeriodUp to 12 months prior to the index date (between 01 October 2016 through 30 June 2022 (patient identification period)).Percentage of participants with hypoxemia in the pre-index baseline period. The Percentage of participants is reported instead of time to hypoxemia in the Outcome Measure Data Table. The pre-index period was defined as the 12-month period prior to the index date. The index date is the first day of follow-up observation time for Aim 2.

Countries

United States

Participant flow

Recruitment details

This was a non-interventional study in patients with Fibrotic Interstitial Lung Disease (ILD) enrolled in a commercial, Medicaid, or Medicare plan, using existing administrative claims and Electronic Health Record (EHR) data in Optum's Market Clarity Integrated Claims + Clinical database for the period of 01 October 2015 through 30 June 2022 (study period). The patient identification period was (01-Oct-2016 through 30-Jun-2022).

Pre-assignment details

All subjects were screened for eligibility prior to participation in the trial.

Participants by arm

ArmCount
Patients With Fibrotic Interstitial Lung Disease (ILD)
Patients aged ≥18 years with ≥2 fibrosing ILD diagnoses and continuous enrollment with medical and pharmacy coverage for 12 months prior to the fibrosing ILD diagnosis date as recorded in a commercial, Medicaid, or Medicare plan, using existing administrative claims and EHR data in Optum's Market Clarity Integrated Claims + Clinical database for the patient identification period (01-Oct-2016 through 30-Jun-2022).
114,921
Total114,921

Baseline characteristics

CharacteristicPatients With Fibrotic Interstitial Lung Disease (ILD)
Age, Continuous66.9 Years
STANDARD_DEVIATION 14.2
Ethnicity (NIH/OMB)
Hispanic or Latino
5455 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
78150 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
31316 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
1824 Participants
Race (NIH/OMB)
Black or African American
11492 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
23861 Participants
Race (NIH/OMB)
White
77744 Participants
Sex: Female, Male
Female
60669 Participants
Sex: Female, Male
Male
54252 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
21,503 / 114,921
other
Total, other adverse events
0 / 0
serious
Total, serious adverse events
0 / 0

Outcome results

Primary

Number of Participants With Disease Progression From Index Date to Follow-up Forced Vital Capacity (FVC) Result

The Number of participants with disease progression is reported instead of time to disease progression in the Outcome Measure Data Table. Disease progression was defined as a 10% relative change between the index date to follow-up FVC result.

Time frame: Up to month 12 of follow-up, in patient identification period from 01 October 2016 through 30 June 2022.

Population: Among the 24,686 fibrosing Interstitial Lung Disease (ILD) patients who initiated oxygen therapy during the Aim 1 follow-up period, 24,680 were successfully matched at a 1:1 ratio with a fibrosing ILD patient who did not yet initiate oxygen therapy.~Patients of the matched cohort are included for which pre-index and follow-up forced vital capacity (FVC) results were available.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Idiopathic Pulmonary Fibrosis (IPF) CohortNumber of Participants With Disease Progression From Index Date to Follow-up Forced Vital Capacity (FVC) Result575 Participants
Non Idiopathic Pulmonary Fibrosis (IPF) CohortNumber of Participants With Disease Progression From Index Date to Follow-up Forced Vital Capacity (FVC) Result456 Participants
Primary

Number of Participants With Disease Progression From Pre-index Forced Vital Capacity (FVC) Result to Index Date

The Number of participants with disease progression is reported instead of time to disease progression in the Outcome Measure Data Table. Disease progression was defined as a 10% relative change between the forced vital capacity (FVC) pre-index value and the index date.

Time frame: Up to 12 months prior to the index date (between 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Among the 24,686 fibrosing Interstitial Lung Disease (ILD) patients who initiated oxygen therapy during the Aim 1 follow-up period, 24,680 were successfully matched at a 1:1 ratio with a fibrosing ILD patient who did not yet initiate oxygen therapy.~Patients of the matched cohort are included for which pre-index and follow-up forced vital capacity (FVC) results were available.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Idiopathic Pulmonary Fibrosis (IPF) CohortNumber of Participants With Disease Progression From Pre-index Forced Vital Capacity (FVC) Result to Index Date162 Participants
Non Idiopathic Pulmonary Fibrosis (IPF) CohortNumber of Participants With Disease Progression From Pre-index Forced Vital Capacity (FVC) Result to Index Date110 Participants
Primary

Sustained Oxygen Therapy Use Within the First 12 Months of Follow-up

The number of participants with ≥ 11 claims for oxygen therapy within 12 months of initiating oxygen therapy is reported. Using claims, sustained oxygen therapy use was defined among patients with at least 12 months of follow-up after the index date (oxygen initiation date), as a binary variable for the presence of ≥11 claims for oxygen therapy in a 12-month period.

Time frame: Up to month 12 of follow-up, in patient identification period from 01 October 2016 through 30 June 2022.

Population: Population AIM 1 include patients newly diagnosed with fibrosing ILD during the patient identification period and met all the eligibility criteria.~Population AIM 1 in this endpoint restricted to patients with sustained oxygen therapy use within 12 months of initiating oxygen therapy patients and with ≥ 11 claims for oxygen therapy within 12 months of initiating oxygen therapy.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Idiopathic Pulmonary Fibrosis (IPF) CohortSustained Oxygen Therapy Use Within the First 12 Months of Follow-up967 Participants
Non Idiopathic Pulmonary Fibrosis (IPF) CohortSustained Oxygen Therapy Use Within the First 12 Months of Follow-up4973 Participants
Primary

Time to All-cause Mortality

Time to all-cause mortality is calculated as time between index date and mortality date. The oxygen therapy cohort index date was defined as the first date of a claim for oxygen therapy. The no oxygen therapy cohort index date was assigned as a date that was eligible to set an index date.

Time frame: Up to 2099 days (from 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Population AIM 2 include ILD patients with ≥1 medical claim for oxygen therapy after fibrosing ILD diagnosis of patients identified for AIM 1 and patients of AIM 1 who matched by propensity score matching (PSM) procedure.~For each oxygen therapy cohort patient, a patient who had not yet initiated oxygen therapy and with the closest available propensity score was selected.

ArmMeasureValue (MEDIAN)
Idiopathic Pulmonary Fibrosis (IPF) CohortTime to All-cause Mortality53.8 Months
Non Idiopathic Pulmonary Fibrosis (IPF) CohortTime to All-cause MortalityNA Months
Primary

Time to Oxygen Therapy Initiation

Time from the fibrosing Interstitial Lung Disease (ILD) diagnosis date to oxygen therapy initiation is reported. Descriptive statistics are rounded to one decimal place.

Time frame: Up to 2099 days (from 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Population AIM 1 include patients newly diagnosed with fibrosing ILD during the patient identification period and met all the eligibility criteria.~Population AIM 1 in this endpoint restricted to patients without baseline oxygen therapy use.

ArmMeasureValue (MEDIAN)
Idiopathic Pulmonary Fibrosis (IPF) CohortTime to Oxygen Therapy Initiation27.5 Months
Non Idiopathic Pulmonary Fibrosis (IPF) CohortTime to Oxygen Therapy InitiationNA Months
Primary

Time to Sustained Oxygen Therapy Use

Time between the fibrosing ILD diagnosis date and the earliest date that defined the sustained oxygen therapy use is reported. Sustained oxygen therapy was defined as ≥ 11 claims for oxygen therapy within 12 months of initiating oxygen therapy.

Time frame: Up to 2099 days (from 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Population AIM 1 include patients newly diagnosed with fibrosing ILD during the patient identification period and met all the eligibility criteria.~Population AIM 1 in this endpoint restricted to patients with sustained oxygen therapy use within 12 months of initiating oxygen therapy patients and with ≥ 11 claims for oxygen therapy within 12 months of initiating oxygen therapy.

ArmMeasureValue (MEDIAN)
Idiopathic Pulmonary Fibrosis (IPF) CohortTime to Sustained Oxygen Therapy Use275 Days
Non Idiopathic Pulmonary Fibrosis (IPF) CohortTime to Sustained Oxygen Therapy Use266 Days
Secondary

Percentage of Participants With Acute Exacerbations in the Pre-index Baseline Period

Percentage of participants with acute exacerbations in the pre-index baseline period. The Percentage of participants is reported instead of time to acute exacerbations in the Outcome Measure Data Table. The pre-index period was defined as the 12-month period prior to the index date. The index date is the first day of follow-up observation time for Aim 2.

Time frame: Up to 12 months prior to the index date (between 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Population AIM 2 include ILD patients with ≥1 medical claim for oxygen therapy after fibrosing ILD diagnosis of patients identified for AIM 1 and patients of AIM 1 who matched by propensity score matching (PSM) procedure.~For each oxygen therapy cohort patient, a patient who had not yet initiated oxygen therapy and with the closest available propensity score was selected.

ArmMeasureValue (NUMBER)
Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Acute Exacerbations in the Pre-index Baseline Period2.8 Percentage of Participants
Non Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Acute Exacerbations in the Pre-index Baseline Period1.3 Percentage of Participants
Secondary

Percentage of Participants With Acute Exacerbations Within the First 12 Month of the Follow up Period

Percentage of participants with acute exacerbations within the first 12 month of the follow up period. The Percentage of participants is reported instead of time to acute exacerbations in the Outcome Measure Data Table. The follow up period (variable period) started on the index date until the earliest of the following: disenrollment from the health plan, death, or the end of the study period.

Time frame: Up to 12 months post index date (between 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Population AIM 2 include ILD patients with ≥1 medical claim for oxygen therapy after fibrosing ILD diagnosis of patients identified for AIM 1 and patients of AIM 1 who matched by propensity score matching (PSM) procedure.~For each oxygen therapy cohort patient, a patient who had not yet initiated oxygen therapy and with the closest available propensity score was selected.

ArmMeasureValue (NUMBER)
Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Acute Exacerbations Within the First 12 Month of the Follow up Period3.5 Percentage of Participants
Non Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Acute Exacerbations Within the First 12 Month of the Follow up Period1.6 Percentage of Participants
Secondary

Percentage of Participants With Hypoxemia in the Pre-index Baseline Period

Percentage of participants with hypoxemia in the pre-index baseline period. The Percentage of participants is reported instead of time to hypoxemia in the Outcome Measure Data Table. The pre-index period was defined as the 12-month period prior to the index date. The index date is the first day of follow-up observation time for Aim 2.

Time frame: Up to 12 months prior to the index date (between 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Population AIM 2 include ILD patients with ≥1 medical claim for oxygen therapy after fibrosing ILD diagnosis of patients identified for AIM 1 and patients of AIM 1 who matched by propensity score matching (PSM) procedure.~For each oxygen therapy cohort patient, a patient who had not yet initiated oxygen therapy and with the closest available propensity score was selected.

ArmMeasureValue (NUMBER)
Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Hypoxemia in the Pre-index Baseline Period57.2 Percentage of Participants
Non Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Hypoxemia in the Pre-index Baseline Period21.0 Percentage of Participants
Secondary

Percentage of Participants With Hypoxemia in the Pre-Interstitial Lung Disease (ILD) Baseline Period

Percentage of participants with hypoxemia in the pre-ILD baseline period. The Percentage of participants is reported instead of time to hypoxemia in the Outcome Measure Data Table. The pre-ILD baseline period is defined as 12 months prior to the fibrosing ILD diagnosis date.

Time frame: Up to 12 months prior to the fibrosing ILD diagnosis date (between 01 October 2016 through 30 June 2022 (patient identification period)).

Population: Population AIM 2 include ILD patients with ≥1 medical claim for oxygen therapy after fibrosing ILD diagnosis of patients identified for AIM 1 and patients of AIM 1 who matched by propensity score matching (PSM) procedure.~For each oxygen therapy cohort patient, a patient who had not yet initiated oxygen therapy and with the closest available propensity score was selected.

ArmMeasureValue (NUMBER)
Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Hypoxemia in the Pre-Interstitial Lung Disease (ILD) Baseline Period19.9 Percentage of Participants
Non Idiopathic Pulmonary Fibrosis (IPF) CohortPercentage of Participants With Hypoxemia in the Pre-Interstitial Lung Disease (ILD) Baseline Period14.8 Percentage of Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026