Abstract Introduction There is growing evidence that medications such as dipeptidyl peptidase 4 inhibitors (DPP-IV inhibitors) exert anti-inflammatory and anti-fibrotic effects with some recent examinations on their role in different disease states including chronic obstructive pulmonary disease (COPD) and in the development of chronic lung allograft dysfunction (CLAD) in post lung transplant patients. We conducted a retrospective analysis of patients included in the Trinetx database to examine the effect of DPP-IV inhibitors on idiopathic fibrosis patients (IPF). Methods The cohort analyzed included adults with a diagnosis of IPF who were receiving DPP-IV inhibitors found within the Trinetx database between 2020-2025. Patients receiving DPP-IV inhibitors were then compared to a cohort of IPF patients not receiving DPP-IV inhibitors after propensity score matching for demographics, antifibrotic use, and smoking history. The outcomes examined included all cause mortality at 5 years, hospitalization, development of pulmonary hypertension, and transplant status at 5 years. Results A total of 38,522 patients were found within the database with 19,261 patients who had received DPP-IV inhibitors and 19,261 patients who had not received any DPP-IV inhibitors who carried a diagnosis of idiopathic pulmonary fibrosis. Mean age at index event was 71 years of age. The cohort was 54% male and 63% white in the DPP-IV group and 68% white in the control group. Incidence of antifibrotic use was 1% of patients in both the control and intervention group. There was a notable difference in 5 year all cause mortality with a HR of 0.93 with a CI (0.893, 0.967); however, there was no notable difference in hospitalization (OR of 0.973 CI of (0.932, 1.02), transplantation (OR 0.833 (0.66, 1.17), or development of pulmonary hypertension (OR of 1.945 CI of (0.81, 1.10) at 5 year follow up. Conclusions In IPF patients who had received DPP-IV inhibitors as part of the management of their type 2 diabetes, there was less observed death at 5 years compared to those who had not though both groups were noted to have similar risk of hospitalization for respiratory failure, development of pulmonary hypertension, and underwent transplant at similar rates. This abstract is funded by: None
Zeineddine et al. (2026) studied this question.