Antifibrotic drugs as treatment of nonidiopathic pulmonary fibrosis interstitial pneumonias: the time is now (?)

Curr Opin Pulm Med. 2017 Sep;23(5):418-425. doi: 10.1097/MCP.0000000000000408.

Abstract

Purpose of review: Therapeutic advances in the management of idiopathic pulmonary fibrosis (IPF) has led to improved outcomes with the use of the antifibrotic agents pirfenidone and nintedanib, with a number of randomized studies demonstrating benefits in slowing disease progression in IPF. However, treatment of other fibrosing interstitial lung diseases (ILD) remains challenging.

Recent findings: Observational and uncontrolled studies investigating pirfenidone and nintedanib in non-IPF ILDs suggest potential benefits, although the data is weak. A number of randomized controlled trials evaluating pirfenidone and nintedanib in a variety of fibrosing ILDs are currently enrolling or planned.

Summary: The review will discuss the rationale for use of established antifibrotic drugs approved for IPF for use in non-IPF ILD, describe supportive data from observational studies and ongoing clinical trials.

Publication types

  • Review

MeSH terms

  • Disease Progression
  • Enzyme Inhibitors / pharmacology
  • Humans
  • Indoles / pharmacology*
  • Lung Diseases, Interstitial* / diagnosis
  • Lung Diseases, Interstitial* / drug therapy
  • Observational Studies as Topic
  • Pyridones / pharmacology*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Enzyme Inhibitors
  • Indoles
  • Pyridones
  • pirfenidone
  • nintedanib