# Treatment Adherence and Persistence of Anti-Fibrotic Drugs in Real Life in Greece

## TL;DR

The study found that women, younger patients, and those with progressive pulmonary fibrosis had better adherence and persistence to anti-fibrotic drugs in Greece.

## Contribution

This study provides novel real-world data on treatment persistence and adherence to anti-fibrotic drugs in Greece, highlighting demographic and diagnostic factors influencing outcomes.

## Key findings

- The median treatment persistence was 40.2 months, with 79% and 63% of patients remaining persistent at 12 and 24 months.
- Women, younger patients, and those with progressive pulmonary fibrosis had higher treatment persistence rates.
- Adherence levels remained high (90%) across the follow-up period, with older age associated with improved adherence.

## Abstract

What are the main findings?
The overall median treatment persistence was 40.2 months with 79%, and 63% of patients remaining persistent at 12 and 24 months, respectively. Women, younger patients and patients with progressive pulmonary fibrosis diagnosis had higher treatment persistence rates compared to their counterparts.Adherence levels remained high across the follow-up period (90%), while older age was associated with improved adherence rates.

The overall median treatment persistence was 40.2 months with 79%, and 63% of patients remaining persistent at 12 and 24 months, respectively. Women, younger patients and patients with progressive pulmonary fibrosis diagnosis had higher treatment persistence rates compared to their counterparts.

Adherence levels remained high across the follow-up period (90%), while older age was associated with improved adherence rates.

What are the implications of the main findings?
Improvement in the clinical management of inhibitory factors, such as adverse events, may improve the persistence rates for men, which represent the majority of patients with interstitial pulmonary fibrosis (IPF) diagnosis.Clinical and demographic factors of each patient should be considered before the launch of anti-fibrotic therapy in order to secure the maximal therapeutic benefits.

Improvement in the clinical management of inhibitory factors, such as adverse events, may improve the persistence rates for men, which represent the majority of patients with interstitial pulmonary fibrosis (IPF) diagnosis.

Clinical and demographic factors of each patient should be considered before the launch of anti-fibrotic therapy in order to secure the maximal therapeutic benefits.

Background: Nintedanib and pirfenidone are two anti-fibrotic agents for diseases within the interstitial lung diseases (ILDs) spectrum. Here, we provide a comprehensive analysis regarding treatment persistence and adherence rates for the Greek territory. Methods: This was a retrospective cohort study of patients initiating anti-fibrotic treatment during the period 2019–2023, utilizing data extracted from the National Electronic Prescription Database. Treatment persistence was defined as the duration from the date of the first prescription to the end of follow-up, death, or switching to another agent. Adherence was estimated based on the Medication Possession Ratio (MPR) metric. Results: Overall, 2112 patients were analyzed. The majority were naive, male patients with a diagnosis of idiopathic pulmonary fibrosis (IPF). The overall median treatment persistence was 40.2 months (95% CI: 35.5–44.6). Women and treatment-naive patients demonstrated longer median treatment persistence compared to their counterparts, while older patients demonstrated the lowest median persistence rates. Adherence levels remained high across the follow-up period (90%). Diagnosis of IPF and gastrointestinal comorbidities were associated with a higher risk of discontinuation. Conclusions: We have generated novel data concerning the factors that affect patients’ outcomes under anti-fibrotic therapy. These findings may provide helpful insights for the therapeutic management of ILDs.