Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30347
Title: Pirfenidone in Progressive Pulmonary Fibrosis: A Systematic Review and Meta-Analysis.
Austin Authors: Ghazipura, Marya;Mammen, Manoj J;Bissell, Brittany D;Macrea, Madalina;Herman, Derrick D;Hon, Stephanie M;Kheir, Fayez;Khor, Yet H ;Knight, Shandra L;Raghu, Ganesh;Wilson, Kevin C;Hossain, Tanzib
Affiliation: Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia
ZS Associates, Global Health Economics and Outcomes Research, New York.
Respiratory and Sleep Medicine
Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine, and.. Pharmacy Practice and Science Department, College of Pharmacy, University of Kentucky, Lexington, Kentucky.
Section of Pulmonary and Sleep Medicine, Department of Medicine, Salem Veterans Affairs Medical Center, Salem, Virginia.
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Wexner Medical Center, The Ohio State University, Columbus, Ohio.
Department of Medicine, School of Medicine, Tufts University, Boston, Massachusetts.
Department of Thoracic Surgery and Interventional Pulmonary, Beth Israel Deaconess Medical Center, Harvard Medical School, Harvard University, Boston, Massachusetts.
Library and Knowledge Sciences, National Jewish Health, Denver, Colorado.
Department of Medicine, School of Medicine, University of Washington, Seattle, Washington.
Department of Medicine, School of Medicine, Boston University, Boston, Massachusetts.
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Grossman School of Medicine, New York University Langone Health, New York, New York.
Issue Date: Jun-2022
Publication information: Annals of the American Thoracic Society 2022-06; 19(6): 1030-1039
Abstract: Background: The American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax convened to update clinical practice guidelines for interstitial lung disease (ILD). Objective: To conduct a systematic review to evaluate existing ILD literature to determine whether patients with progressive pulmonary fibrosis (PPF) should be treated with the antifibrotic pirfenidone. Data Sources: A literature search was conducted across MEDLINE, EMBASE, and Cochrane databases through December 2020 for studies using pirfenidone to treat patients with PPF. Data Extraction: Mortality, disease progression, lung function, and adverse event data were extracted. Meta-analyses were performed when possible. The Grading of Recommendations, Assessment, Development and Evaluation Working Group approach was used to assess the quality of evidence. Synthesis: Two studies met inclusion criteria. Meta-analyses revealed that changes in forced vital capacity (FVC) percent predicted (mean difference [MD], 2.3%; 95% confidence interval [CI], 0.5-4.1%), the FVC in milliliters (MD, 100.0 ml; 95% CI, 98.1-101.9 ml), and the 6-minute-walk distance in meters (MD, 25.2 m; 95% CI, 8.3-42.1 m) all favored pirfenidone over placebo. The changes in the diffusing capacity of the lung for carbon monoxide (DLCO) in millimoles per kilopascal per minute (MD, 0.40 mmol/kPa/min; 95%, CI 0.10-0.70 mmol/kPa/min) and risk of DLCO declining more than 15% (relative risk [RR], 0.27; 95% CI, 0.08-0.95) also favored pirfenidone. The risks of gastrointestinal discomfort (RR, 1.83; 95% CI, 1.29-2.60) and photosensitivity (RR, 4.88; 95% CI, 1.09-21.83) were higher with pirfenidone. The quality of the evidence was low or very low according to the Grading of Recommendations, Assessment, Development and Evaluation criteria, depending on the outcome. Conclusions: Pirfenidone use in patients with PPF is associated with a statistically significant decrease in disease progression and with protection of lung function. However, there is very low certainty in the estimated effects because of limitations in the available evidence. Primary Source of Funding: Funded by the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax.
URI: https://ahro.austin.org.au/austinjspui/handle/1/30347
DOI: 10.1513/AnnalsATS.202103-342OC
ORCID: 0000-0003-4328-6822
0000-0003-0343-3234
0000-0002-7345-9731
0000-0002-5352-9587
0000-0002-0390-8407
0000-0002-4192-5080
0000-0002-4404-3833
0000-0001-7506-6643
0000-0003-4429-2263
0000-0002-1995-7828
0000-0002-5434-9342
Journal: Annals of the American Thoracic Society
PubMed URL: 35499847
Type: Journal Article
Subjects: antifibrotic
idiopathic pulmonary fibrosis
interstitial lung disease
pirfenidone
progressive pulmonary fibrosis
Appears in Collections:Journal articles

Show full item record

Page view(s)

22
checked on May 28, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.