Efficacy and Safety of Pirfenidone in Patients with Progressive Pulmonary Fibrosis: A Retrospective Single-Center Study

TL;DR

This study evaluates how well pirfenidone works and its safety in treating progressive pulmonary fibrosis, finding it may slow lung function decline.

Contribution

The study provides new evidence on the efficacy of pirfenidone for progressive pulmonary fibrosis in real-world clinical settings.

Findings

Pirfenidone treatment was associated with a significant improvement in forced vital capacity (FVC) over six months.

Adverse events related to pirfenidone were mild, indicating a favorable safety profile.

Rheumatoid arthritis-related interstitial lung disease was the most common subtype among study participants.

Abstract

Progressive pulmonary fibrosis (PPF) is an emerging subset of fibrotic interstitial lung diseases (ILD), defined by progressive fibrosis despite standard treatment in patients with other than idiopathic pulmonary fibrosis. The international guidelines recommended the use of nintedanib for PPF, while evidence supporting pirfenidone remains insufficient. In this study, we aimed to evaluate the efficacy and safety of pirfenidone in treating PPF. In this retrospective single-center study, we analyzed clinical data from patients with PPF who were treated with pirfenidone. Lung function data from six months before and after pirfenidone treatment were collected to assess changes over time. Missing values were imputed using a general linear mixed model (GLMM) for longitudinal data analysis. Of 33 subjects, the median age was 65.0 years, and 51.5% were female. Rheumatoid arthritis-related ILD was the most common subtype (45.5%). The median daily dose of pirfenidone was 600 mg, with a median treatment duration of 7.3 months. GLMM analysis showed a significant forced vital capacity (FVC) improvement, from −114 mL in the 6 months before treatment to +47.3 mL in the 6 months after treatment (p = 0.001). All adverse events related to pirfenidone were mild. In conclusion, the use of pirfenidone in PPF can potentially reduce the rate of FVC decline in real clinical practice.

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