Real-world experiences: Efficacy and tolerability of pirfenidone in clinical practice

Abstract

BackgroundThe safety of pirfenidone on pulmonary fibrosis patients with other kinds of interstitial lung diseases (ILDs) in addition to idiopathic pulmonary fibrosis (IPF) is unknown. Furthermore, its effectiveness-related factors on IPF patients are not quite explored. MethodsA retrospective study, on patients prescribed pirfenidone for pulmonary fibrosis, was conducted to assess effectiveness on IPF patients and tolerability of all patients with lung fibrosis. The effectiveness of pirfenidone was tested on 110 IPF subjects receiving treatment for �3 months by high-resolution computed tomography (HRCT). Response-linked factors and progression-free survival (PFS) were also analyzed. The data about safety outcomes and drug dose adjustments were collected from all included subjects. ResultsA total of 176 subjects were included: 117 were IPF, 19 connective tissue disease-associated interstitial lung disease (CTD-ILD), and 40 unclassifiable ILD. Out of the 110 IPF subjects, 89 subjects were assessed as stable and 21 as progressive, out of which 10 died of acute exacerbation and 11 progressed. The effectiveness was significantly related to their baseline body mass index (BMI). IPF subjects with BMI>25kg/m 2 or diffusion capacity of carbon monoxide (DLco)>30% had higher PFS rate. The most common adverse events were skin-related and gastrointestinal-related. Drug discontinuation owing to adverse events occurred similarly in these three groups.

A real world retrospective observational study exploring the effectiveness and safety of antifibrotics in idiopathic pulmonary fibrosis

“…Our results are surprising as it appears patients with a normal BMI are at an increased risk of dying. However, this nding, alongside DLco as a predictor of mortality, is consistent with Fang et al's real world pirfenidone study [28]. We also noted that baseline BMI was a predictor of anti brotic discontinuation, which has been reported previously [29], with Kato et al [30] nding that low BMI increases the risk of experiencing nintedanib-associated gastrointestinal side effects.…”

Real-world retrospective observational study exploring the effectiveness and safety of antifibrotics in idiopathic pulmonary fibrosis

“…However, this finding, alongside DLco as a predictor of mortality, is consistent with Fang et al ’s real-world pirfenidone study. 28 We also noted that baseline BMI was a predictor of antifibrotic discontinuation, which has been reported previously, 29 with Kato et al 30 finding that low BMI increases the risk of experiencing nintedanib-associated gastrointestinal side effects.…”

Real-life experiences in a single center: efficacy of pirfenidone in idiopathic pulmonary fibrosis and fibrotic idiopathic non-specific interstitial pneumonia patients

“…Finally, the factors which might affect the efficacy of pirfenidone were not analyzed. One study reported that IPF patients with a >25 kg/m 2 in body mass index (BMI) or a >30% in DLco had a higher progression-free survival rate, 28 but similar analyses were not performed in our study due to the limited quality and information of patients.…”