Switching antifibrotics in patients with idiopathic pulmonary fibrosis: a multi-center retrospective cohort study

Currently, there are two antifibrotics used to treat idiopathic pulmonary fibrosis (IPF): pirfenidone and nintedanib. Antifibrotics slow disease progression by reducing the annual decline of forced vital capacity (FVC), which possibly improves outcomes in IPF patients. During treatment, patients occ...

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Bibliographic Details
Published in:BMC pulmonary medicine 2021-07, Vol.21 (1), p.221-13, Article 221
Main Authors: Suzuki, Yuzo, Mori, Kazutaka, Aono, Yuya, Kono, Masato, Hasegawa, Hirotsugu, Yokomura, Koshi, Naoi, Hyogo, Hozumi, Hironao, Karayama, Masato, Furuhashi, Kazuki, Enomoto, Noriyuki, Fujisawa, Tomoyuki, Nakamura, Yutaro, Inui, Naoki, Nakamura, Hidenori, Suda, Takafumi
Format: Article
Language:English
Subjects:
Aged
Antifibrotic therapy
Cohort analysis
Disease
Disease Progression
Drug Administration Schedule
Drug Substitution
Drug therapy
Female
Fibrosis
Gastrointestinal diseases
Humans
Idiopathic pulmonary fibrosis
Idiopathic Pulmonary Fibrosis - drug therapy
Indoles - therapeutic use
Japan
Lung diseases
Male
Medical prognosis
Patients
Prognosis
Propensity Score
Pulmonary fibrosis
Pulmonology
Pyridones - therapeutic use
Regression analysis
Retrospective Studies
Software
Survival
Switch of antifibrotics
Treatment Outcome
Values
Vital Capacity
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Summary:Currently, there are two antifibrotics used to treat idiopathic pulmonary fibrosis (IPF): pirfenidone and nintedanib. Antifibrotics slow disease progression by reducing the annual decline of forced vital capacity (FVC), which possibly improves outcomes in IPF patients. During treatment, patients occasionally switch antifibrotic treatments. However, prognostic implication of changing antifibrotics has not yet been evaluated. This multi-center retrospective cohort study examined 262 consecutive IPF patients who received antifibrotic therapy. Antifibrotic agents were switched in 37 patients (14.1%). The prognoses were compared between the patient cohort that switched antifibrotics (Switch-IPF) and those without (Non-Switch-IPF) using propensity-score matched analyses. The median period between the initiation of antifibrotic therapy and the drug switch was 25.8 (12.7-35.3) months. The most common reasons for the switch were disease progression (n = 17) followed by gastrointestinal disorders (n = 12). Of the 37 patients that switched antifibrotics, only eight patients disrupted switched antifibrotics by their adverse reactions. The overall prognosis of the Switch-IPF cohort was significantly better than the Non-Switch-IPF cohort (median periods: 67.2 vs. 27.1 months, p 
ISSN:1471-2466
1471-2466
DOI:10.1186/s12890-021-01587-3