Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis

Abstract

Pirfenidone is one of two approved therapies for the treatment of idiopathic pulmonary fibrosis (IPF). Randomised controlled clinical trials and subsequent post hoc analyses have demonstrated that pirfenidone reduces lung function decline, decreases mortality and improves progression-free survival. Long-term extension trials, registries and real-world studies have also shown similar treatment effects with pirfenidone. However, for patients with IPF to obtain the maximum benefits of pirfenidone treatment, the potential adverse events (AEs) associated with pirfenidone need to be managed. This review highlights the well-known and established safety profile of pirfenidone based on randomised controlled clinical trials and real-world data. Key strategies for preventing and managing the most common pirfenidone-related AEs are described, with the goal of maximising adherence to pirfenidone with minimal AEs.

FIGURE 1

Kaplan–Meier analysis of time to first occurrence of a pirfenidone-related adverse event (AE) as measured from randomisation, irrespective of treatment duration, in the pooled phase III clinical trials. GI: gastrointestinal. ^#: includes all AEs of nausea; these AEs are also included in the group “GI disorders”.