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Review
. 2016 Sep 2;5(9):78.
doi: 10.3390/jcm5090078.

Real World Experiences: Pirfenidone and Nintedanib are Effective and Well Tolerated Treatments for Idiopathic Pulmonary Fibrosis

Gareth Hughes  1   2 , Hannah Toellner  3 , Helen Morris  4 , Colm Leonard  5   6 , Nazia Chaudhuri  7   8
Affiliations
Review

Real World Experiences: Pirfenidone and Nintedanib are Effective and Well Tolerated Treatments for Idiopathic Pulmonary Fibrosis

Gareth Hughes et al. J Clin Med. .

Abstract

Idiopathic Pulmonary Fibrosis (IPF) now has two licensed treatments available. Pirfenidone was the first drug to be licensed and approved for use, followed by nintedanib. We set out our real world experience with these agents in terms of their adverse events profile outside the restrictions of a clinical trial. We have demonstrated in the real world setting, that side effects are common and predominantly gastrointestinal with both therapies. Our study shows that the side effects can be effectively managed in the majority of patients with an acceptable discontinuation rate similar to that seen in the clinical trials. These findings are compelling despite the fact that the patients in our study are older, have severer disease as depicted by baseline lung function and more co-morbidities. Our data provides ongoing evidence of the safety and tolerability of both pirfenidone and nintedanib in patients who would not have met the rigorous criteria to be included in a clinical trial. Both these agents are effective in the management of IPF and slow the progression of this debilitating life limiting condition.

Keywords: IPF; Idiopathic Pulmonary Fibrosis; nintedanib; pirfenidone.

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Conflict of interest statement

G.H. and H.T. declare no conflict of interests. H.M. attended a Roche conference (AIR) and received funding for a postgraduate course from Intermune. C.L. has received educational funding from Intermune and Boehringer Ingelheim. N.C. has received educational funding from Intermune and Boehringer Ingelheim.

Figures

Figure 1
Figure 1
Frequency of Adverse Events with Pirfenidone.
Figure 2
Figure 2
Impact of AE on treatment with Pirfenidone.
Figure 3
Figure 3
Impact of age, BMI, FVC, DLCO and duration of treatment on discontinuations due to AEs (Where *** denotes p < 0.001)
Figure 3
Figure 3
Impact of age, BMI, FVC, DLCO and duration of treatment on discontinuations due to AEs (Where *** denotes p < 0.001)
Figure 4
Figure 4
Reduction in decline of mean FVC before and after pirfenidone treatment.
Figure 5
Figure 5
Percentage change in FVC from baseline before and after treatment with pirfenidone.
Figure 6
Figure 6
Frequency of Adverse Events with Nintedanib.
See this image and copyright information in PMC

References

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    1. National Institute for Health and Care Excellence . NICE Technology Appraisal Guidance (TA282) National Institute for Health and Care Excellence; Manchester, UK: 2013. Pirfenidone for treating idiopathic pulmonary fibrosis.
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