Low-dose pirfenidone is beneficial for the survival and lung function in patients with idiopathic pulmonary fibrosis (IPF), according to the results of a real-world study published in PLOS One.
“We suggest that continuation of the medication, even at low doses, can be beneficial for IPF patients,” Eung Gu Lee and the coauthors of the study wrote. “Physicians should consider dose reduction rather than discontinuation of the patient’s condition permits this.”
Pirfenidone is often used for the treatment of patients with IPF. The present study evaluated the effects of low-dose pirfenidone on disease progression and patient survival in the real world.
The researchers compared the clinical characteristics, survival, and decline in lung function of 100 patients with IPF treated with various doses of pirfenidone and compared them to that of 195 patients who were untreated.
Of the 100 patients treated with pirfenidone, 24 received 600 mg per day, 50 received 1200 mg per day, and 26 received 1800 mg per day.
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The results showed that the mean survival time of patients who were not treated was 57.03 months whereas it was 73.26 months in those treated with pirfenidone.
The researchers also compared the lung function of patients in the 2 groups. They found that the decrease in forced vital capacity, forced expiratory volume in 1 second, and the diffusing capacity of the lungs for carbon monoxide was significantly smaller in patients who received pirfenidone compared to those who did not.
Pirfenidone regulates proinflammatory and profibrotic cytokine cascades. Animal experiments have shown that it can reduce the proliferation of fibroblasts and the synthesis of collagen, and clinical trials have indicated that it may reduce mortality in patients with IPF. Nintedanib is also an available treatment for IPF.
Lee EG, Lee TH, Hong Y, et al. Effects of low-dose pirfenidone on survival and lung function decline in patients with idiopathic pulmonary fibrosis (IPF): results from a real-world study. PLOS One. 2021;16(12):e0261684. doi:10.1371/journal.pone.0261684