Institutional patterns in diagnosis and antifibrotic-era treatment uptake for IPF and PPF across U.S. centers

Bradley A Sheffield, Brian J Cassel, Apostolos Perelas, Patricia Sime and Peter Jackson

PLOS ONE, 2026, vol. 21, issue 10, 1-12

Abstract: Purpose: For ten years, nintedanib and pirfenidone have been the only approved therapies for idiopathic pulmonary fibrosis (IPF), with nintedanib subsequently also approved for progressive pulmonary fibrosis (PPF). Previous studies demonstrate low antifibrotic (AF) uptake, but differences by site-of-care and AF uptake after seminal trials (IPF: INPULSIS/ASCEND; PPF: INBUILD) are not well characterized. We evaluated temporal trends in IPF and PPF diagnosis and AF use at academic (AC) versus non-academic (NonAC) centers. Methods: Using the U.S. TriNetX Collaborative Network, we compared IPF and PPF incidence, prevalence, and AF use by center type using linear regression across post-trial and post–FDA-approval windows (IPF: 2015–2017, 2015–2024; PPF: 2020–2022, 2020–2024). Slope differences (Δslope) were calculated as AC minus NonAC annual slopes; therefore, positive values indicate faster increases at ACs, whereas negative values indicate faster increases at NonACs. Results: Across both periods, IPF prevalence increased more rapidly at NonACs, while AF use was higher at ACs (2024: 33.5% vs 20.1%, p

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0360987

DOI: 10.1371/journal.pone.0360987

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