- Email: [email protected]
The Efficacy of Pirfenidone in the Treatment of Idiopathic Pulmonary Fibrosis: A Single-Institution Retrospective Study in Japan
Diffuse Lung Disease SESSION TITLE: Evaluation and Treatment of ILD SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM
The Efficacy of Pirfenidone in the Treatment of Idiopathic Pulmonary Fibrosis: A Single-Institution Retrospective Study in Japan Kai Yazaki MD* Yukiko Miura MD Manato Taguchi MD Shunichi Nishima MD Norihito Hida MD Kazufumi Yoshida MD Kentaro Hyodo MD Jun Kanazawa MD Kenji Nemoto MD Takio Takaku MD Shuji Oishi MD Kenji Hayashihara MD; and Takefumi Saito MD NHO Ibarakihigashi National Hospital, Naka-gun, Japan PURPOSE: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal disease. The 2011 ATS/ERS/JRS/ALAT guideline did not recommend drug therapy, but Pirfenidone and Nintedanib became “conditional recommendation for use” on the 2015 guideline because these were proved to reduce disease progression in patients with IPF. To assess the other efficacy of Pirfenidone, we examined Japanese patients with IPF. METHODS: We retrospectively examined Japanese patients with IPF to assess mortality rates and the proportion of acute exacerbation and lung cancer. Patients with IPF were diagnosed from 2009 to 2014 and observed for more than one year until 2015.
CONCLUSIONS: In Japanese patients with IPF, Pirfenidone might reduce the proportion of lung cancer. In the survival group, Pirfenidone reduced the relative %VC decline. The respiratory failure death was more in Pirfenidone group than in nonPirfenidone group. In Pirfenidone group,however, the relative %VC decline was not worse in respiratory failure death than in the other causes of death. The respiratory failure death might not be associated with pulmonary function decline. CLINICAL IMPLICATIONS: Another antifibrotic agent, Nintedanib is known to have a treatment effect on lung cancer and Pirfenidone might also have a preventive effect on lung cancer. Further confirmatory trial is needed. DISCLOSURE: The following authors have nothing to disclose: Kai Yazaki, Yukiko Miura, Manato Taguchi, Shunichi Nishima, Norihito Hida, Kazufumi Yoshida, Kentaro Hyodo, Jun Kanazawa, Kenji Nemoto, Takio Takaku, Shuji Oishi, Kenji Hayashihara, Takefumi Saito No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.497
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
483A
DIFFUSE LUNG DISEASE
RESULTS: Among 94 patients, 35 patients (37.2%) were given Pirfenidone and 69 (62.8%) were not. Average duration of treatment with Pirfenidone was 37.6 month. Baseline characteristics for Pirfenidone versus non-Pirfenidone groups were were not significantly different(mean age- 68.1 versus 68.7 years old, male rate-77.1% versus 79.7%, smoker rate-74.3% versus 78.0%, mean %VC- 78.1% versus 76.8%, mean %DLco- 61.0% versus 60.8%). There was no significant difference between Pirfenidone and nonPirfenidone groups in both mortality rate (p¼0.131) and the proportion of acute exacerbation (p¼0.367). The proportion of lung cancer was, however, 2.9% with Pirfenidone versus 20.3% with non-Pirfenidone (p¼0.014). The causes of death in Pirfenidone versus non-Pirfenidone groups were : acute exacerbation- 33.3% versus 36.7%, respiratory failure- 33.3% versus 13.3%, pneumonia- 16.7% versus 20.0%, lung cancer- 0% versus 13.3%. Relative %VC decline with Pirfenidone was -8.1%/year in the death group, and 2.6%/year in the survival group. And relative %VC declines based on causes of death were -11.6%/year in acute exacerbation , -10.2%/year in respiratory infection and -4.6%/year in respiratory failure.
The Efficacy of Pirfenidone in the Treatment of Idiopathic Pulmonary Fibrosis: A Single-Institution Retrospective Study in Japan Kai Yazaki MD* Yukiko Miura MD Manato Taguchi MD Shunichi Nishima MD Norihito Hida MD Kazufumi Yoshida MD Kentaro Hyodo MD Jun Kanazawa MD Kenji Nemoto MD Takio Takaku MD Shuji Oishi MD Kenji Hayashihara MD; and Takefumi Saito MD NHO Ibarakihigashi National Hospital, Naka-gun, Japan PURPOSE: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal disease. The 2011 ATS/ERS/JRS/ALAT guideline did not recommend drug therapy, but Pirfenidone and Nintedanib became “conditional recommendation for use” on the 2015 guideline because these were proved to reduce disease progression in patients with IPF. To assess the other efficacy of Pirfenidone, we examined Japanese patients with IPF. METHODS: We retrospectively examined Japanese patients with IPF to assess mortality rates and the proportion of acute exacerbation and lung cancer. Patients with IPF were diagnosed from 2009 to 2014 and observed for more than one year until 2015.
CONCLUSIONS: In Japanese patients with IPF, Pirfenidone might reduce the proportion of lung cancer. In the survival group, Pirfenidone reduced the relative %VC decline. The respiratory failure death was more in Pirfenidone group than in nonPirfenidone group. In Pirfenidone group,however, the relative %VC decline was not worse in respiratory failure death than in the other causes of death. The respiratory failure death might not be associated with pulmonary function decline. CLINICAL IMPLICATIONS: Another antifibrotic agent, Nintedanib is known to have a treatment effect on lung cancer and Pirfenidone might also have a preventive effect on lung cancer. Further confirmatory trial is needed. DISCLOSURE: The following authors have nothing to disclose: Kai Yazaki, Yukiko Miura, Manato Taguchi, Shunichi Nishima, Norihito Hida, Kazufumi Yoshida, Kentaro Hyodo, Jun Kanazawa, Kenji Nemoto, Takio Takaku, Shuji Oishi, Kenji Hayashihara, Takefumi Saito No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.497
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
483A
DIFFUSE LUNG DISEASE
RESULTS: Among 94 patients, 35 patients (37.2%) were given Pirfenidone and 69 (62.8%) were not. Average duration of treatment with Pirfenidone was 37.6 month. Baseline characteristics for Pirfenidone versus non-Pirfenidone groups were were not significantly different(mean age- 68.1 versus 68.7 years old, male rate-77.1% versus 79.7%, smoker rate-74.3% versus 78.0%, mean %VC- 78.1% versus 76.8%, mean %DLco- 61.0% versus 60.8%). There was no significant difference between Pirfenidone and nonPirfenidone groups in both mortality rate (p¼0.131) and the proportion of acute exacerbation (p¼0.367). The proportion of lung cancer was, however, 2.9% with Pirfenidone versus 20.3% with non-Pirfenidone (p¼0.014). The causes of death in Pirfenidone versus non-Pirfenidone groups were : acute exacerbation- 33.3% versus 36.7%, respiratory failure- 33.3% versus 13.3%, pneumonia- 16.7% versus 20.0%, lung cancer- 0% versus 13.3%. Relative %VC decline with Pirfenidone was -8.1%/year in the death group, and 2.6%/year in the survival group. And relative %VC declines based on causes of death were -11.6%/year in acute exacerbation , -10.2%/year in respiratory infection and -4.6%/year in respiratory failure.