Real-Life Experience with Pirfenidone in Idiopathic Pulmonary Fibrosis in Argentina. A Retrospective Multicenter Study

Arch Bronconeumol (Engl Ed). 2019 Feb;55(2):75-80. doi: 10.1016/j.arbres.2018.06.014. Epub 2018 Jul 23.
[Article in English, Spanish]

Abstract

Introduction: Pirfenidone was the first antifibrotic drug approved in Argentina for idiopathic pulmonary fibrosis (IPF). Outcomes in real life may differ from the results of clinical trials. The primary endpoint was to study the tolerance of pirfenidone in real life. Secondary endpoints were to analyze effectiveness and reasons for discontinuation.

Materials and methods: Retrospective observational study conducted in 4 specialized centers in Argentina. We analyzed the medical records of patients with IPF who received pirfenidone between June 2013 and September 2016. Adverse events (AE) and the variables that could influence these results were analyzed. Forced vital capacity (FVC%) parameters were also compared between the pre-pirfenidone and post-pirfenidone periods.

Results: Fifty patients were included, 38 (76%) men, with mean age (SD) 67.8 (8.36) years. Mean (SD) exposure to pirfenidone was 645.68 (428.19) days, with a mean daily dose (SD) of 2,064.56mg (301.49). Nineteen AEs in 15 patients (30%) were reported: nausea (14%), asthenia (10%) and skin rash (8%). A total of 18 patients (36%) interrupted treatment, only 1 definitively. The most frequent reason for discontinuation was failure of suppliers to provide the drug (9 subjects; 18%). We compared the evolution of FVC% between the pre-pirfenidone and post-pirfenidone periods, and found a mean (SD) FVC% decline of 4.03% (7.63) pre-pirfenidone and 2.64% (7.1) post-pirfenidone (P=.534).

Conclusions: In our study, pirfenidone was well tolerated and associated with a reduction in FVC decline, although without reaching statistical significance.

Keywords: Fibrosis pulmonar idiopática; Idiopathic pulmonary fibrosis; Pirfenidona; Pirfenidone; Real life; Vida real.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Argentina
  • Asthenia / chemically induced
  • Clinical Trials, Phase III as Topic
  • Exanthema / chemically induced
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / drug therapy*
  • Idiopathic Pulmonary Fibrosis / physiopathology
  • Male
  • Nausea / chemically induced
  • Pyridones / adverse effects
  • Pyridones / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Treatment Outcome
  • Vital Capacity / drug effects

Substances

  • Pyridones
  • pirfenidone