Monocyte count as a prognostic biomarker in patients with idiopathic pulmonary fibrosis

Michael Kreuter, Joyce S. Lee, Argyrios Tzouvelekis, Justin M. Oldham, Philip L. Molyneaux, Derek Weycker, Mark Atwood, Klaus Uwe Kirchgaessler, Toby M. Maher

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Rationale: There is an urgent need for simple, cost-effective prognostic biomarkers for idiopathic pulmonary fibrosis (IPF); biomarkers that show potential include monocyte count. Objectives: We used pooled data from pirfenidone and IFNg-1b trials to explore the association between monocyte count and prognosis in patients with IPF. Methods: This retrospective pooled analysis included patients (active and placebo arms) from the following four phase III, randomized, placebo-controlled trials: ASCEND (NCT01366209), CAPACITY (NCT00287729 and NCT00287716), and INSPIRE (NCT00075998). Outcomes included IPF progression (≥10% absolute decline in FVC% predicted,≥50mdecline in 6-minute-walk distance, or death), all-cause hospitalization, and all-cause mortality over 1 year. The relationship between monocyte count (defined as time-dependent) and outcomes was assessed using bivariate and multivariable models. Measurements and Main Results: This analysis included 2,067 patients stratified by monocyte count (at baseline:,0.60×109 cells/L [n =1,609], 0.60 to <0.95×109 cells/L [n=408], and ≥0.95×109 cells/L [n =50]). In adjusted analyses, a higher proportion of patients with monocyte counts of 0.60 to <0.95×109 cells/L or ≥0.95×109 cells/L versus <0.60×109 cells/L experienced IPF progression (P=0.016 and P = 0.002, respectively), all-cause hospitalization (P=0.030 and P = 0.003, respectively), and all-cause mortality (P=0.005 and P<0.001, respectively) over 1 year. Change inmonocyte count frombaseline was not associated with any of the outcomes over 1 year and did not appear to be affected by study treatment. Conclusions: In patients with IPF, elevated monocyte count was associated with increased risks of IPF progression, hospitalization, and mortality. Monocyte count may provide a simple and inexpensive prognostic biomarker in IPF.

Original languageEnglish (US)
Pages (from-to)74-81
Number of pages8
JournalAmerican journal of respiratory and critical care medicine
Issue number1
StatePublished - Jul 1 2021
Externally publishedYes


  • Biomarkers
  • Prognosis
  • Pulmonary fibrosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


Dive into the research topics of 'Monocyte count as a prognostic biomarker in patients with idiopathic pulmonary fibrosis'. Together they form a unique fingerprint.

Cite this