Introduction and objectives Idiopathic Pulmonary Fibrosis (IPF) is strongly associated with advanced age. Our aim is to identify if the baseline characteristics of patients aged >80 who are excluded from pharmaceutical trials differ compared to patients aged <80 years.

Methods Consecutively diagnosed IPF patients ≥80 (n = 61) and <80 (n = 320) presenting to the ILD Unit of the Royal Brompton Hospital from 1/1/2010 to 31/12/2013 were included in this analysis. Data regarding age, smoking status, pulmonary function tests including (FEV₁, FVC, DLco and Kco) were extracted from medical records. All cases were discussed by an ILD multi-disciplinary panel for the purpose of assigning a consensus diagnosis.

Results The baseline characteristics of both study groups are summarised in Table 1. Patients were also grouped by smoking status; the smoking history of 10 patients in the ≥80 and 3 patients in the <80 groups was unavailable.

We divided both groups to smokers and non-smokers. FEV₁ and FVC did not differ between non-smokers from both study groups whereas were both significantly lower in the smokers aged <80 years than in smokers aged >80 years (74,44 ± 18,24 versus 86,34 ± 12,67 p = 0.0005 for FEV₁ and 72,96 ± 20,77 versus 88,34 ± 13,68 p = 0.0001 for FVC). DLco and Kco did not differ between smokers and non-smokers.

Conclusion Patients with IPF aged ≥80 years present with higher spirometric values than those < 80 in particular when a history of smoking is taken into consideration. Mean FVC did not differ between the non-smoking cohorts in each age-separated group while baseline DLco and Kco were not different between the two study groups regardless of smoking status. The higher FVC in smokers with IPF aged >80 compared to younger smokers could be due to the concomitant presence of radiologically evident emphysema. This finding has clinical implications with respect to eligibility for NICE-approved anti-fibrotic treatment. Analysis of the extent of emphysema in these patients and further studies of a higher number of patients is underway.