Impact of novel antifibrotic therapy on patient outcomes in idiopathic pulmonary fibrosis: patient selection and perspectives

• Published in: Patient related outcome measures Vol. 9; pp. 321 - 328
• Main Authors: Graney, Bridget A, Lee, Joyce S
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Binding sites; Care and treatment; Caregivers; Clinical medicine; Clinical trials; Comorbidity; Decision making; Development and progression; Diarrhea; Dyspnea; Enzymes; FDA approval; Fibrosis; Growth factors; idiopathic pulmonary fibrosis; Interstitial lung disease; Lung diseases; Nintedanib; Oxygen therapy; Patient outcomes; patient reported outcome measures; Patients; Pirfenidone; Pulmonary fibrosis; Quality of life; Questionnaires; Respiratory tract diseases; Retirement benefits; Review; Sleep apnea; United States > US; nintedanib; idiopathic pulmonary fibrosis; quality of life; interstitial lung disease; pirfenidone; patient-reported outcome measures
• ISSN: 1179-271X; 1179-271X
• DOI: 10.2147/prom.s144425

Patients with idiopathic pulmonary fibrosis, an incurable, progressive fibrotic interstitial lung disease, suffer an impaired quality of life due to symptoms, resultant functional limitations, and the constraints of supplemental oxygen. Two antifibrotic medications, nintedanib and pirfenidone, are approved for the treatment of idiopathic pulmonary fibrosis. Both medications slow the rate of decline of lung function, but their effect on patient-reported outcomes is not yet fully understood. Nintedanib may slow the decline in health-related quality of life for treated patients. Pirfenidone may slow the progression of dyspnea and improve cough. Patients and providers should participate in shared decision-making when starting antifibrotic therapy, taking into consideration the benefits of treatment in addition to drug-related side effects and dosing schedules. Although antifibrotic therapy may have an impact on health-related quality of life, providers should also focus on comprehensive care of the patient to improve health-related outcomes. This includes a multidisciplinary evaluation, diagnosis and treatment of comorbid medical conditions, and referral to and participation in a pulmonary rehabilitation program.