Pirfenidone‐induced severe phototoxic reaction in a patient with idiopathic lung fibrosis

Abstract

To our knowledge, this is the first reported case of a severe phototoxic reaction during treatment with pirfenidone. Our aim by presenting this case is to increase the awareness of clinicians for severe phototoxic effects of oral pirfenidone.

Pirfenidone photosensitization in patients with idiopathic pulmonary fibrosis: a case series

“…To our knowledge, this study represents the largest documented series of PFD photosensitivity because only sporadic case reports have been published. [2][3][4][5][6] One-fifth of our patients were photosensitive, consistent with data from PFD safety analysis. 1 Our patients seen by a dermatologist had clinical features of phototoxicity.…”

“…All were treated with the maximum dose of PFD. Photobiochemical studies demonstrated the phototoxicity of PFD, confirmed by clinical reported cases . Our results do not indicate that phototoxicity is linked to the metabolism of porphyrins or niacin.…”

“…Photobiochemical studies demonstrated the phototoxicity of PFD, 7 confirmed by clinical reported cases. 2,3 Our results do not indicate that phototoxicity is linked to the metabolism of porphyrins or niacin. In patients with low niacin serum concentration we did not assess their diets and found no drug-induced niacin deficiency.…”

Untitled

“…However they render only temporary medical effect at an mild to moderate forms of diseases, and in severe form they not only inefficient, but also are toxic [22]. In particular, they have high hepato-gastrointestinal toxicity [23], skin phototoxic reactions, up to a leukomelanoderma [24][25][26]. Besides, neither nintedanib, nor pirfenidon not at all patients prevent progressing of fibrosis [27,28].…”

Untitled

“…However they render only temporary medical effect at an mild to moderate forms of diseases, and in severe form they not only inefficient, but also are toxic [22]. In particular, they have high hepato-gastrointestinal toxicity [23], skin phototoxic reactions, up to a leukomelanoderma [24][25][26]. Besides, neither nintedanib, nor pirfenidon not at all patients prevent progressing of fibrosis [27,28].…”