Elevations in NLR at the first year of pirfenidone treatment may be associated with worse prognosis in patients with idiopathic pulmonary fibrosis

The purpose of this study was to evaluate the hemogram parameters, namely NLR and PLR, at the end of the first year of antifibrotic treatment in IPF patients and evaluate the association of change in NLR and PLR levels and mortality in this study population. Patients diagnosed with IPF and started on antifibrotic therapy between 2016 and 2022 were included. Study design was retrospective cohort study. Baseline NLR and PLR values were obtained at the time of diagnosis before any treatment was started. Follow-up levels of NLR and PLR were obtained at the completion of the first year of antifibrotic treatment. A total of 125 patients were included in the study. Mean age was 67.9 ± 7.27 years. It was found that increment in NLR at first year was significant in non-survived group (p = 0.01). When patients were separated into four groups according to their survival status and antifibrotic medication, significant NLR and PLR elevations were only present in non-survived pirfenidone group (p = 0.02 and p = 0.01). Elevated levels of NLR at the first year of antifibrotic treatment may be a sign of worse prognosis in IPF patients, especially in patients treated with pirfenidone.