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The tolerability and efficacy of antifibrotic therapy in patients with idiopathic pulmonary fibrosis: Results from a real-world study
Idiopathic pulmonary fibrosis is a progressive and fatal lung disease lacking effective therapeutics. Treatment with pirfenidone or nintedanib is recommended for patients to delay the progression of their disease. Adverse reactions caused by anti-fibrosis drugs can sometimes interrupt treatment and...
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| Published in: | Pulmonary pharmacology & therapeutics 2024-03, Vol.84, p.102287-102287, Article 102287 |
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| container_end_page | 102287 |
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| container_start_page | 102287 |
| container_title | Pulmonary pharmacology & therapeutics |
| container_volume | 84 |
| creator | Zhao, Ruiming Xie, Bingbing Wang, Xin Zhang, Xinran Ren, Yanhong Wang, Chen Dai, Huaping |
| description | Idiopathic pulmonary fibrosis is a progressive and fatal lung disease lacking effective therapeutics. Treatment with pirfenidone or nintedanib is recommended for patients to delay the progression of their disease. Adverse reactions caused by anti-fibrosis drugs can sometimes interrupt treatment and even change the progression of the disease.
This study aimed to investigate the clinical use, adverse reactions, tolerability of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis and the efficacy of antifibrotic therapy in a real world.
We recruited patients with idiopathic pulmonary fibrosis treated with pirfenidone or nintedanib at China-Japan Friendship Hospital from February 2017 to February 2022. We investigated the medication situation, adverse reactions, tolerability and survival of patients taking medications.
A total of 303 patients with idiopathic pulmonary fibrosis were enrolled in the study. Treatment was divided between 205 patients receiving pirfenidone and 98 patients receiving nintedanib. Baseline data between the two groups were not significantly different. Patients treated with nintedanib had a higher overall discontinuation rate than those treated with pirfenidone (61.22 vs. 32.68 %, p |
| doi_str_mv | 10.1016/j.pupt.2024.102287 |
| format | article |
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This study aimed to investigate the clinical use, adverse reactions, tolerability of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis and the efficacy of antifibrotic therapy in a real world.
We recruited patients with idiopathic pulmonary fibrosis treated with pirfenidone or nintedanib at China-Japan Friendship Hospital from February 2017 to February 2022. We investigated the medication situation, adverse reactions, tolerability and survival of patients taking medications.
A total of 303 patients with idiopathic pulmonary fibrosis were enrolled in the study. Treatment was divided between 205 patients receiving pirfenidone and 98 patients receiving nintedanib. Baseline data between the two groups were not significantly different. Patients treated with nintedanib had a higher overall discontinuation rate than those treated with pirfenidone (61.22 vs. 32.68 %, p < 0.001). Across all patient groups, the most common reason for discontinuing treatment was medication-related adverse effects. Compared to pirfenidone, nintedanib had a significantly higher discontinuation rate due to adverse events (48.98 % vs 27.80 %, p < 0.001). The most common side effect of both drugs was diarrhea. Pirfenidone was associated with a higher rate of extra-digestive adverse effects than nintedanib. Survival was not significantly different between the two drugs and using pirfenidone above 1200 mg/day did not confer significant survival benefits. The survival rate of patients who adhere to anti-fibrosis therapy for more than 6 months can be significantly improved (HR = 0.323, p = 0.0015).
Gastrointestinal adverse effects were the most common adverse effects and the main reason of discontinuation of antifibrotic therapy, especially nintedanib. Consistent adherence to antifibrotic therapy may make the patients benefit from adjusting their antifibrotic medications, dosage, and active management of side effects.</description><identifier>ISSN: 1094-5539</identifier><identifier>EISSN: 1522-9629</identifier><identifier>DOI: 10.1016/j.pupt.2024.102287</identifier><identifier>PMID: 38242314</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adverse event ; Antifibrotic treatment ; Discontinuation ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis ; Japan ; Nintedanib ; Pirfenidone ; Pyridones - adverse effects ; Survival Rate ; Treatment Outcome</subject><ispartof>Pulmonary pharmacology & therapeutics, 2024-03, Vol.84, p.102287-102287, Article 102287</ispartof><rights>2024 Elsevier Ltd</rights><rights>Copyright © 2024 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-3127f3848a6dd6d3a86bd1c525bc502eb02b815489f925e39e6ebe6b477627fe3</citedby><cites>FETCH-LOGICAL-c356t-3127f3848a6dd6d3a86bd1c525bc502eb02b815489f925e39e6ebe6b477627fe3</cites><orcidid>0000-0002-8344-1965</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38242314$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhao, Ruiming</creatorcontrib><creatorcontrib>Xie, Bingbing</creatorcontrib><creatorcontrib>Wang, Xin</creatorcontrib><creatorcontrib>Zhang, Xinran</creatorcontrib><creatorcontrib>Ren, Yanhong</creatorcontrib><creatorcontrib>Wang, Chen</creatorcontrib><creatorcontrib>Dai, Huaping</creatorcontrib><title>The tolerability and efficacy of antifibrotic therapy in patients with idiopathic pulmonary fibrosis: Results from a real-world study</title><title>Pulmonary pharmacology & therapeutics</title><addtitle>Pulm Pharmacol Ther</addtitle><description>Idiopathic pulmonary fibrosis is a progressive and fatal lung disease lacking effective therapeutics. Treatment with pirfenidone or nintedanib is recommended for patients to delay the progression of their disease. Adverse reactions caused by anti-fibrosis drugs can sometimes interrupt treatment and even change the progression of the disease.
This study aimed to investigate the clinical use, adverse reactions, tolerability of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis and the efficacy of antifibrotic therapy in a real world.
We recruited patients with idiopathic pulmonary fibrosis treated with pirfenidone or nintedanib at China-Japan Friendship Hospital from February 2017 to February 2022. We investigated the medication situation, adverse reactions, tolerability and survival of patients taking medications.
A total of 303 patients with idiopathic pulmonary fibrosis were enrolled in the study. Treatment was divided between 205 patients receiving pirfenidone and 98 patients receiving nintedanib. Baseline data between the two groups were not significantly different. Patients treated with nintedanib had a higher overall discontinuation rate than those treated with pirfenidone (61.22 vs. 32.68 %, p < 0.001). Across all patient groups, the most common reason for discontinuing treatment was medication-related adverse effects. Compared to pirfenidone, nintedanib had a significantly higher discontinuation rate due to adverse events (48.98 % vs 27.80 %, p < 0.001). The most common side effect of both drugs was diarrhea. Pirfenidone was associated with a higher rate of extra-digestive adverse effects than nintedanib. Survival was not significantly different between the two drugs and using pirfenidone above 1200 mg/day did not confer significant survival benefits. The survival rate of patients who adhere to anti-fibrosis therapy for more than 6 months can be significantly improved (HR = 0.323, p = 0.0015).
Gastrointestinal adverse effects were the most common adverse effects and the main reason of discontinuation of antifibrotic therapy, especially nintedanib. Consistent adherence to antifibrotic therapy may make the patients benefit from adjusting their antifibrotic medications, dosage, and active management of side effects.</description><subject>Adverse event</subject><subject>Antifibrotic treatment</subject><subject>Discontinuation</subject><subject>Fibrosis</subject><subject>Humans</subject><subject>Idiopathic Pulmonary Fibrosis</subject><subject>Japan</subject><subject>Nintedanib</subject><subject>Pirfenidone</subject><subject>Pyridones - adverse effects</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>1094-5539</issn><issn>1522-9629</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kMtu1DAUhiNERS_wAiyQl2wy-BInMWKDKihIlZCqdm35cqzxyImD7VDlAfreeJjCkpWPj77_SP_XNG8J3hFM-g-H3bIuZUcx7eqC0nF40VwQTmkreipe1hmLruWcifPmMucDxnjoGH_VnLORdpSR7qJ5ut8DKjFAUtoHXzakZovAOW-U2VB09V-88zrF4g0q-wouG_IzWlTxMJeMHn3ZI299rJt9ZZY1THFWaUN_Ytnnj-gO8hoq61KckEIJVGgfYwoW5bLa7XVz5lTI8Ob5vWoevn65v_7W3v64-X79-bY1jPelZYQOjo3dqHpre8vU2GtLDKdcG44paEz1SHg3CicoByagBw297oahr0lgV837090lxZ8r5CInnw2EoGaIa5ZUkIHzgYqhovSEmlohJ3BySX6qrSTB8qhfHuRRvzzqlyf9NfTu-f6qJ7D_In99V-DTCYDa8peHJLOpFg1Yn8AUaaP_3_3fMUOZVA</recordid><startdate>202403</startdate><enddate>202403</enddate><creator>Zhao, Ruiming</creator><creator>Xie, Bingbing</creator><creator>Wang, Xin</creator><creator>Zhang, Xinran</creator><creator>Ren, Yanhong</creator><creator>Wang, Chen</creator><creator>Dai, Huaping</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8344-1965</orcidid></search><sort><creationdate>202403</creationdate><title>The tolerability and efficacy of antifibrotic therapy in patients with idiopathic pulmonary fibrosis: Results from a real-world study</title><author>Zhao, Ruiming ; Xie, Bingbing ; Wang, Xin ; Zhang, Xinran ; Ren, Yanhong ; Wang, Chen ; Dai, Huaping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-3127f3848a6dd6d3a86bd1c525bc502eb02b815489f925e39e6ebe6b477627fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adverse event</topic><topic>Antifibrotic treatment</topic><topic>Discontinuation</topic><topic>Fibrosis</topic><topic>Humans</topic><topic>Idiopathic Pulmonary Fibrosis</topic><topic>Japan</topic><topic>Nintedanib</topic><topic>Pirfenidone</topic><topic>Pyridones - adverse effects</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhao, Ruiming</creatorcontrib><creatorcontrib>Xie, Bingbing</creatorcontrib><creatorcontrib>Wang, Xin</creatorcontrib><creatorcontrib>Zhang, Xinran</creatorcontrib><creatorcontrib>Ren, Yanhong</creatorcontrib><creatorcontrib>Wang, Chen</creatorcontrib><creatorcontrib>Dai, Huaping</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pulmonary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhao, Ruiming</au><au>Xie, Bingbing</au><au>Wang, Xin</au><au>Zhang, Xinran</au><au>Ren, Yanhong</au><au>Wang, Chen</au><au>Dai, Huaping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The tolerability and efficacy of antifibrotic therapy in patients with idiopathic pulmonary fibrosis: Results from a real-world study</atitle><jtitle>Pulmonary pharmacology & therapeutics</jtitle><addtitle>Pulm Pharmacol Ther</addtitle><date>2024-03</date><risdate>2024</risdate><volume>84</volume><spage>102287</spage><epage>102287</epage><pages>102287-102287</pages><artnum>102287</artnum><issn>1094-5539</issn><eissn>1522-9629</eissn><abstract>Idiopathic pulmonary fibrosis is a progressive and fatal lung disease lacking effective therapeutics. Treatment with pirfenidone or nintedanib is recommended for patients to delay the progression of their disease. Adverse reactions caused by anti-fibrosis drugs can sometimes interrupt treatment and even change the progression of the disease.
This study aimed to investigate the clinical use, adverse reactions, tolerability of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis and the efficacy of antifibrotic therapy in a real world.
We recruited patients with idiopathic pulmonary fibrosis treated with pirfenidone or nintedanib at China-Japan Friendship Hospital from February 2017 to February 2022. We investigated the medication situation, adverse reactions, tolerability and survival of patients taking medications.
A total of 303 patients with idiopathic pulmonary fibrosis were enrolled in the study. Treatment was divided between 205 patients receiving pirfenidone and 98 patients receiving nintedanib. Baseline data between the two groups were not significantly different. Patients treated with nintedanib had a higher overall discontinuation rate than those treated with pirfenidone (61.22 vs. 32.68 %, p < 0.001). Across all patient groups, the most common reason for discontinuing treatment was medication-related adverse effects. Compared to pirfenidone, nintedanib had a significantly higher discontinuation rate due to adverse events (48.98 % vs 27.80 %, p < 0.001). The most common side effect of both drugs was diarrhea. Pirfenidone was associated with a higher rate of extra-digestive adverse effects than nintedanib. Survival was not significantly different between the two drugs and using pirfenidone above 1200 mg/day did not confer significant survival benefits. The survival rate of patients who adhere to anti-fibrosis therapy for more than 6 months can be significantly improved (HR = 0.323, p = 0.0015).
Gastrointestinal adverse effects were the most common adverse effects and the main reason of discontinuation of antifibrotic therapy, especially nintedanib. Consistent adherence to antifibrotic therapy may make the patients benefit from adjusting their antifibrotic medications, dosage, and active management of side effects.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38242314</pmid><doi>10.1016/j.pupt.2024.102287</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-8344-1965</orcidid></addata></record> |
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| source | ScienceDirect Freedom Collection |
| subjects | Adverse event Antifibrotic treatment Discontinuation Fibrosis Humans Idiopathic Pulmonary Fibrosis Japan Nintedanib Pirfenidone Pyridones - adverse effects Survival Rate Treatment Outcome |
| title | The tolerability and efficacy of antifibrotic therapy in patients with idiopathic pulmonary fibrosis: Results from a real-world study |
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