PT  - JOURNAL ARTICLE
AU  - Takuya Takaiwa
AU  - Hiromasa Tachibana
AU  - Machiko Arita
AU  - Tadashi Ishida
TI  - Long term efficacy of pirfenidone therapy in patients with idiopathic pulmonary fibrosis (IPF)
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P785
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P785.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P785.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background:Pirfenidone has been used for the treatment of IPF in Japan since 2008. However, the long term efficacy of the drug remains unclear.Purpose:To evaluate the efficacy of pirfenidone therapy for ≥6 months and identify the predictive factors for drug responseMethods:Between July 2010 and August 2013, 38 patients underwent pirfenidone therapy for clinico-radiologically diagnosed IPF based on an official ATS/ERS/JRS/ALAT statement published in 2011. We evaluated the efficacy on the chronological changes of percent forced vital capacity (%FVC), percent diffusing capacity for carbon monoxide (%DLCO), and composite physiologic index (CPI). Patients were divided into two groups; patients who continued the therapy for ≥6 months, tolerable group, and patients who withdrew the therapy, intolerable group. We investigated baseline characteristics between two groups.Results:Twenty-five patients continued the therapy for ≥6 months. In the tolerable group, the mean changes of %FVC were -2.872% (-6-0month), +2.565% (0-6months), -1.017% (6-12months), and -6.398% (12-18months), and the mean changes of %DLCO and CPI were similar.In the same group, linear mixed-effects model analysis showed that pirfenidone significantly improved %FVC at 6 months, %DLCO at 6 and 12 months, and CPI at 6 and 12 months. In the tolerable group, the baseline %FVC and %DLCO were significantly higher (p=0.004, 0.033 respectively), and the baseline CPI was significantly lower (p=0.011) than in the intolerable group.Conclusion:Our results suggest that pirfenidone is effective for 12 months but ineffective at 18 months and that drug response is better in patients with good pulmonary function on the baseline.