In patients with idiopathic pulmonary fibrosis (IPF), the effects of antifibrotic agents on the prognosis remain unclear. This study aimed to investigate the impact of antifibrotic treatment on the risks of mortality, hospitalisation, and acute exacerbation in real-world patients with IPF. A total of 1213 IPF patients (biopsy-proven cases: 405) were included in this retrospective study. Propensity score matching was used to adjust for differences in baseline characteristics between patients who received antifibrotic treatment and who did not. A Cox proportional hazard model was used to compare the risks of all-cause mortality, hospitalisation, acute exacerbation, and mortality following acute exacerbation between the two groups. From the 1213 patients, 474 matched pairs were generated. The mean age of the patients in the matched cohort was 65.8 years and 82.8% were men. The median follow-up duration was 27 months. Antifibrotic treatment significantly reduced the risks of mortality [hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.48–0.72; p < 0.001], all-cause hospitalisation (HR 0.71), respiratory-related hospitalisation (HR 0.67), acute exacerbation (HR 0.69), and mortality after acute exacerbation (HR 0.60). Our results suggest that antifibrotic treatment may reduce the risks of all-cause mortality, hospitalisation, acute exacerbation, and mortality after acute exacerbation in patients with IPF.

在特发性肺纤维化 (IPF) 患者中，抗纤维化药物对预后的影响尚不清楚。本研究旨在调查抗纤维化治疗对真实世界 IPF 患者的死亡、住院和急性加重风险的影响。这项回顾性研究共纳入了 1213 名 IPF 患者（活检证实的病例：405 名）。倾向评分匹配用于调整接受抗纤维化治疗和未接受抗纤维化治疗的患者之间基线特征的差异。使用 Cox 比例风险模型比较两组之间的全因死亡、住院、急性加重和急性加重后死亡率的风险。从 1213 名患者中，生成了 474 对配对。匹配队列中患者的平均年龄为 65 岁。8 岁和 82.8% 是男性。中位随访时间为 27 个月。抗纤维化治疗显着降低了死亡风险 [风险比 (HR)，0.59；95% 置信区间 (CI)，0.48-0.72；p <0.001]、全因住院（HR 0.71）、呼吸相关住院（HR 0.67）、急性加重（HR 0.69）和急性加重后死亡率（HR 0.60）。我们的研究结果表明，抗纤维化治疗可能会降低 IPF 患者的全因死亡、住院、急性加重和急性加重后死亡的风险。呼吸相关住院 (HR 0.67)、急性加重 (HR 0.69) 和急性加重后死亡率 (HR 0.60)。我们的研究结果表明，抗纤维化治疗可能会降低 IPF 患者的全因死亡、住院、急性加重和急性加重后死亡的风险。呼吸相关住院 (HR 0.67)、急性加重 (HR 0.69) 和急性加重后死亡率 (HR 0.60)。我们的研究结果表明，抗纤维化治疗可能会降低 IPF 患者的全因死亡、住院、急性加重和急性加重后死亡的风险。