Composite clinical outcome not improved with co-trimoxazole in idiopathic pulmonary fibrosis trial

Co-trimoxazole did not reduce a composite outcome of time to death, transplant, or nonelective hospitalization compared with placebo in patients with moderate or severe idiopathic pulmonary fibrosis (IPF), according to a study published in JAMA.

In this double-blind, placebo-controlled, parallel randomized trial, 342 patients with IPF, breathlessness, and impaired lung function, were randomized to receive 960 mg of oral co-trimoxazole twice daily (n = 170) or matched placebo (n = 172) for between 12 and 42 months.

Out of the 342 patients who started the trial, 83% (n = 283) completed it, with a median follow-up time of 1.02 years.

Events per person-year of follow-up were 0.45 (84/186) in patients randomized to receive co-trimoxazole and 0.38 (80/209) in patients receiving placebo.

No statistically significant differences in other event outcomes, lung function, or patient-reported outcomes were found.

Patients in the co-trimoxazole group and placebo group had 696 and 640 adverse events, respectively.

Reference

Wilson AM, Clark AB, Cahn T, et al. Effect of co-trimoxazole (Trimethoprim-Sulfamethoxazole) vs placebo on death, lung transplant, or hospital admission in patients with moderate and severe idiopathic pulmonary fibrosis: The EME-TIPAC Randomized Clinical Trial. JAMA. 2020;324(22):2282–2291. doi:10.1001/jama.2020.22960.