Predictors of the clinical effects of pirfenidone on idiopathic pulmonary fibrosis

Arai, Toru; Inoue, Yoshikazu; Sasaki, Yumiko; Tachibana, Kazunobu; Nakao, Keiko; Sugimoto, Chikatoshi; Okuma, Tomohisa; Akira, Masanori; Kitaichi, Masanori; Hayashi, Seiji

doi:10.1016/j.resinv.2013.09.002

Cited by 46 publications

(28 citation statements)

References 28 publications

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“…In addition to long-term observational studies, a number of recent single-centre studies have been published reporting the efficacy and tolerability of pirfenidone in a real-world setting (table 3) [13][14][15][16][17][18][19][20]. Generally, these single-centre observational studies demonstrate that in daily clinical practice the tolerability of pirfenidone is comparable to the literature with a positive effect in terms of clinical efficacy in the majority of patients treated, particularly regarding disease stabilisation and prevention of pulmonary function decline.…”

Section: Single-centre Real-world Experience With Pirfenidonementioning

confidence: 99%

Long-term clinical and real-world experience with pirfenidone in the treatment of idiopathic pulmonary fibrosis

2015

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Idiopathic pulmonary fibrosis (IPF) is a chronic, irreversible, progressively destructive lung disease that culminates in respiratory failure and death. Randomised controlled trials have demonstrated that treatment of IPF patients with pirfenidone reduces lung function decline, improves progression-free survival and significantly reduces the risk of all-cause mortality at 1 year. Pirfenidone has been shown to have a favourable safety profile and was generally well tolerated over the long term in clinical trials and realworld experience. However, side-effect management is critical to help some patients remain on treatment over the long term. The primary treatment-related adverse events associated with pirfenidone therapy are gastrointestinal upset, rash and photosensitivity. Gastrointestinal events may be mitigated by ensuring that pirfenidone is taken with food, while skin symptoms may be reduced by avoiding sun exposure and frequent use of sunblock. Educating patients about the potential for these adverse events to occur and providing instructions prior to treatment to avoid adverse drug reactions are an important means of ensuring patients may derive the important benefits provided by long-term treatment with pirfenidone. @ERSpublications Patient education is critical to help IPF patients manage side-effects of pirfenidone and remain on treatment http://ow.ly/HaPak

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Section: Single-centre Real-world Experience With Pirfenidonementioning

confidence: 99%

Long-term clinical and real-world experience with pirfenidone in the treatment of idiopathic pulmonary fibrosis

2015

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“…The study by ARAI et al [20] is also from Japan. This study investigated possible predictors of response to therapy with pirfenidone in 41 patients with IPF: diagnosis by a surgical lung biopsy and milder disease were predictors of good, short-term responsiveness.…”

Section: Real-life Clinical Experience With Pirfenidone In Ipfmentioning

confidence: 99%

“…In 10 patients with milder disease (out of 21 patients evaluated), the change in vital capacity (VC) 3 and 12 months before and 3 and 6 months after initiation of pirfenidone therapy was significantly decreased ( p=0.0039), although this was not the case in the other, more severe patients (n=11). Additionally, ARAI et al [20] suggested that patients taking acid-secretion inhibitors, including proton pump inhibitors and histamine H2-receptor antagonists, showed less anorexia, less nausea or both.…”

Section: Real-life Clinical Experience With Pirfenidone In Ipfmentioning

confidence: 99%

Idiopathic pulmonary fibrosis: from clinical trials to real-life experiences

Harari

2015

Eur Respir Rev

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Randomised controlled clinical trials are fundamental in medicine to develop new effective drugs and new therapeutic regimens and are the strength of evidence-based medicine. These studies allow us to avoid the repetition of misleading experiences that have been reported in the past, where drugs or associations were utilised without compelling evidence and ultimately proven to be ineffective. In recent years, randomised clinical trials have been conducted and concluded for many rare diseases, including idiopathic pulmonary fibrosis. However, clinical trials do not always reflect the real-life scenario. Patients selected for clinical trials present fewer comorbidities, they fall between certain age limits, and the severity of their disease is defined; therefore, they do not always reflect the whole of the population affected by a specific disease. These are the reasons why we also need data that mirror real-life experience. The limitations that these kind of studies present are always several and the studies should be interpreted with caution, although they can fill the important gap between efficacy and effectiveness. In this article, we will review the existing clinical data on real-life treatment of idiopathic pulmonary fibrosis. @ERSpublications Real-life studies are useful in confirming the experimental data obtained from randomised controlled clinical trials http://ow.ly/PYUCC

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“…2011-2014: long-term and real-world experience in the treatment of IPF with pirfenidone Since the approval of pirfenidone in 2011 by the EMA, important data on the use of pirfenidone from clinical studies, long-term observational studies and real-world practice has been accumulated, demonstrating that pirfenidone significantly reduces forced vital capacity (FVC) decline and slows disease progression in IPF [22][23][24][25][26][27][28][29][30]. These longer term studies also showed that pirfenidone is generally well tolerated.…”

Section: Introductionmentioning

confidence: 99%

The changing treatment landscape in idiopathic pulmonary fibrosis

Costabel

2015

Eur Respir Rev

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Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and irreversible fibrotic disease of the lung that has greatly frustrated clinicians for a long time. The prognosis of IPF (median survival 2-5 years following diagnosis) is poorer than that of some cancers and for many years no significant advances were made in its management. However, between 2011 and 2014 a number of pivotal developments were made that have improved the outlook for patients with IPF. Herein, we review this rapidly changing landscape, discussing key events whilst still acknowledging that IPF remains a challenging disease to diagnose and manage. @ERSpublications Idiopathic pulmonary fibrosis has become a treatable disease, with two drugs now approved for this indication

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Predictors of the clinical effects of pirfenidone on idiopathic pulmonary fibrosis

Cited by 46 publications

References 28 publications

Long-term clinical and real-world experience with pirfenidone in the treatment of idiopathic pulmonary fibrosis

Long-term clinical and real-world experience with pirfenidone in the treatment of idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis: from clinical trials to real-life experiences

The changing treatment landscape in idiopathic pulmonary fibrosis

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