Correlation between home and clinic spirometry in subjects with IPF: results from the INMARK trial*

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Introduction: Frequent home-based spirometry may provide more accurate estimates of lung function in patients with IPF than intermittent spirometry performed at clinic visits. Aim: To assess the relationship between home and clinic spirometry in the INMARK trial. Methods: Subjects with IPF and FVC ≥ 80% predicted were randomised to receive nintedanib or placebo for 12 weeks, followed by open-label nintedanib for 40 weeks. Subjects were asked to perform home spirometry at least once a week and ideally daily. Clinic spirometry was conducted at baseline and weeks 4, 8, 12, 16, 20, 24, 36 and 52. Correlations between home and clinic measurements of FVC (mL) and FEV 6 (mL) at each time point, and between home- and clinic-measured rates of FVC decline at each time point, were assessed using Pearson correlation coefficients (r). Results: Among all treated subjects (n = 346), strong correlations were observed between home and clinic measurements of FVC (r = 0.72 to 0.84) and FEV 6 (r = 0.71 to 0.85) at all time points. In the 116 subjects treated with nintedanib for 52 weeks, home- and clinic-measured rates of FVC decline were − 127 and − 89 mL/52 weeks, respectively, and the home-measured rate of FEV 6 decline was − 113 mL/52 weeks. Correlations between rates of FVC decline based on home versus clinic spirometry were weak but increased over 52 weeks (r = 0.00 and r = 0.26 for the rate of decline over 4 and 52 weeks, respectively). Conclusions: In subjects with IPF and preserved FVC, home and clinic measurements of FVC and FEV 6 at visits over 52 weeks were strongly correlated. These data suggest that home-based spirometry might be a feasible way to monitor lung function in patients with IPF over 52 weeks. * presented at ERS 2019, ‡ presenting on behalf of the authors

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