Pirfenidone may protect against progression, death in idiopathic pulmonary fibrosis
Treatment with pirfenidone may lead to significantly reduced risks of multiple progression events and death in patients with idiopathic pulmonary fibrosis (IPF), according to a study.
Researchers used data from the phase III trials ASCEND and CAPACITY and identified patients (n=1,247; mean age 68 years; 74.4 percent male) treated with pirfenidone 2,403 mg/day (n=623) or placebo (n=624). The main outcome was disease progression events over 12 months.
Disease progression events were characterized by a relative decline in % predicted forced vital capacity (FVC) ≥10 percent, absolute decline in 6-metre walking distance (6MWD) ≥50 m, respiratory hospitalization or death from any cause.
Based on pooled data, the most common disease progression events were declines in % predicted FVC (202 vs 304 events) and in 6MWD (265 vs 348 events), both occurring with greater frequency among patients on pirfenidone.
However, significantly fewer patients who received pirfenidone vs placebo experienced >1 progression event (17.0 percent vs 30.1 percent; p<0.0001) or died following ≥1 progression event (2.1 percent vs 6.3 percent; p=0.0002).
Compared with placebo, pirfenidone was associated with a lower risk of experiencing a single progression event (hazard ratio [HR], 0.71; 95 percent CI, 0.61–0.82; p<0.0001) and a second progression event (HR, 0.53; 0.42–0.67; p<0.0001).
The present data indicate that continued treatment with pirfenidone confers a benefit in IPF despite the occurrence of any single disease progression event, researchers said.