Gender differences in idiopathic pulmonary fibrosis (IPF) from the British Thoracic Society (BTS) UK ILD registry.

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Background: IPF is a male predominance disease and male gender is associated with poorer prognosis. Objectives: This study aimed to explore gender differences in clinical characteristic, management, and outcomes among IPF patients in the BTS UK ILD registry. Methods: Participating centres entered data into a central electronic database between January 2013 and May 2024. Informed consent was obtained from all participants. A cox proportional hazard analysis was performed separately for males and females. Result: Among 6,666 patients, 77.9% were males. Smoking history was more common in males than females (69.9% vs. 59.9%, P<0.001). Males had higher rates of diabetes (19.7% vs. 14.6%, P<0.001) and ischemic heart disease (IHD) (19.9% vs. 11.2%, P<0.001), while hiatus hernia was more prevalent in females (8.0% vs. 6.4%, P=0.027). Baseline predicted forced vital capacity (FVC) % was lower in males than females (78.8±17.2 vs. 84.1±19.3, P<0.001). No difference was found in diffusion capacity for carbon monoxide (DLCO) and age between males and females. Males were more likely to receive antifibrotic therapy (47.2% vs. 41.6%, P<0.001). Males had a mean survival of 3.22 years compared to females of 3.46 years (P=0.003). In males, IHD (HR 1.27, P=0.001), hiatus hernia (HR 0.74, P=0.033), lower baseline predicted % in FVC (HR 1.01, P<0.001), and DLCO (HR 1.024, P<0.001) predicted mortality. In females, symptom duration >12 months (HR 1.59, P=0.002) and lower baseline % predicted in DLCO (HR 1.023, P<0.001) were significant prognostic factors. Conclusion: Gender differences in IPF emphasise the need for gender-specific approaches in its management.

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