Pirfenidone and Nintedanib in idiopathic pulmonary fibrosis: Real-life experience in an Italian referral centre

• Published in: Pulmonology Vol. 25; no. 3; pp. 149 - 153
• Main Authors: Bargagli, E., Piccioli, C., Rosi, E., Torricelli, E., Turi, L., Piccioli, E., Pistolesi, M., Ferrari, K., Voltolini, L.
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España, S.L.U 01.05.2019; Elsevier España
• Subjects: Aged; Aged, 80 and over; Female; Humans; Idiopathic pulmonary fibrosis; Idiopathic Pulmonary Fibrosis - drug therapy; Idiopathic Pulmonary Fibrosis - physiopathology; Indoles - administration & dosage; Indoles - therapeutic use; Italy; Male; Middle Aged; Nintedanib; Pirfenidone; Pyridones - administration & dosage; Pyridones - therapeutic use; Respiratory Function Tests; Retrospective Studies; Treatment Outcome; Italy; ILD; Nintedanib; HRCT; LFT; Pirfenidone; Idiopathic pulmonary fibrosis
• ISSN: 2531-0437; 2531-0437
• DOI: 10.1016/j.pulmoe.2018.06.003

Idiopathic pulmonary fibrosis has a median survival time after diagnosis of 2–5 years. The main goal of treating IPF is to stabilize or reduce the rate of disease progression. Nintedanib and Pirfenidone have been a breakthrough in the management of IPF. Here we evaluated the effectiveness of Pirfenidone and Nintedanib in a population of IPF patients diagnosed in the last 12 months at Florence ILD Referral Centre. In the last 12 months, 82 IPF patients (66 male, mean age 78.3±23.8 years) were diagnosed and started antifibrotic therapy with Pirfenidone or Nintedanib. Their clinical and functional details were analyzed retrospectively at time 0 and after 6 and 12 months of therapy. The median age of the patients treated with Nintedanib was higher than that of the Pirfenidone group (p<0.0001). The most common symptoms at disease onset were exertional dyspnoea and dry cough with no differences between the two groups (p<0.05). All IPF patients manifested bibasal crackles at the time of diagnosis. No significant differences in FVC, FEV1, TLC and DLCO were found at time 0 or after 6 months between patients treated with Pirfenidone and Nintedanib (p>0.05). After 1 year, lung function test parameters of patients treated with Pirfenidone had remained stable from baseline. This study emphasizes that both antifibrotic drugs appeared to be a good therapeutic choice in terms of functional stabilization, also in older patients.