Choice of antifibrotic medication and disease severity predict weight loss in idiopathic pulmonary fibrosis

Pulm Pharmacol Ther. 2019 Dec:59:101839. doi: 10.1016/j.pupt.2019.101839. Epub 2019 Sep 10.

Abstract

Purpose: Although safety and tolerability of approved antifibrotics has been reported extensively, little is known about their effects on weight. We analyzed predictors of weight change after one year of uninterrupted antifibrotic therapy in patients followed at our institution's interstitial lung disease clinic.

Methods/results: We identified 80 patients on antifibrotic therapy (44 pirfenidone/36 nintedanib) with at least one year of follow-up and no therapy interruptions. Thirty-five patients (44%) lost more than 5% of their baseline body weight, and 11 (19%) lost more than 10%. A higher proportion of patients on nintedanib experienced a clinically significant weight loss (>5%) versus pirfenidone (61% vs 30%, p = 0.005). Univariate and multivariate analyses identified nintedanib therapy and a higher composite physiologic index (CPI) as predictors of weight loss.

Conclusions: Weight loss is common among IPF patients on antifibrotic therapy. Nintedanib therapy and more advanced disease were identified as predictors of weight loss in this population.

Keywords: Body mass index; Idiopathic pulmonary fibrosis; Nintedanib; Pirfenidone; Weight loss.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Idiopathic Pulmonary Fibrosis / drug therapy*
  • Idiopathic Pulmonary Fibrosis / physiopathology
  • Indoles / administration & dosage*
  • Indoles / adverse effects
  • Male
  • Middle Aged
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects
  • Pyridones / administration & dosage*
  • Pyridones / adverse effects
  • Severity of Illness Index
  • Weight Loss / drug effects*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Indoles
  • Protein Kinase Inhibitors
  • Pyridones
  • pirfenidone
  • nintedanib