PT  - JOURNAL ARTICLE
AU  - Hayton, Conal
AU  - Morris, Helen
AU  - Marshall, Tracey
AU  - Zakis, Katie
AU  - Garfoot, Theresa
AU  - Rivera Ortega, Pilar
AU  - Greaves, Melanie
AU  - Leonard, Colm
AU  - Chaudhuri, Nazia
TI  - Antifibrotic choice in idiopathic pulmonary fibrosis
AID  - 10.1183/13993003.congress-2018.PA2953
DP  - 2018 Sep 15
TA  - European Respiratory Journal
PG  - PA2953
VI  - 52
IP  - suppl 62
4099  - http://erj.ersjournals.com/content/52/suppl_62/PA2953.short
4100  - http://erj.ersjournals.com/content/52/suppl_62/PA2953.full
SO  - Eur Respir J2018 Sep 15; 52
AB  - Introduction: Pirfenidone and nintedanib are therapeutic options in IPF. Treatment choice is based on physician-patient discussion regarding suitability and side effect profile.Aims: To establish the proportion of patients in whom antifibrotic choice is physician or patient-led and reasons for choice.Methods: Patients with an MDT diagnosis of IPF initiated on antifibrotic therapy between Oct 17-Jan 18 were included. Demographic data, treatment choice and reason for choice was collected.Results: 51 patients (mean age 72, 80.4% male) started on antifibrotic therapy; 27 (52.9%) nintedanib and 24 (47.1%) pirfenidone.In 22 (43.1%) patients the choice of antifibrotic was physician-led; pirfenidone in 13 (59.1%) and nintedanib in 9 (40.9%). Reasons for physician choice of pirfenidone included concomitant anticoagulation (69.2%), active angina (7.7%), liver cirrhosis (7.7%) and physician preference (15.4%). Reasons for physician choice of nintedanib included history of skin cancer (44.5%), concomitant UV light treatment (11.1%), CKD (11.1%), weight loss (22.2%) and constipation (11.1%).In 29 (56.9%) cases the choice was patient-led. Patients chose nintedanib in 18 (62.1%) cases and pirfenidone in 11 (37.9%). Patients choosing pirfenidone over nintedanib wanted to avoid the side effect of diarrhoea. Reasons for choosing nintedanib included reluctance to apply sunscreen (44.5%), pill burden (27.8%), constipation (16.7%), photosensitivity (5.5%), and indigestion (5.5%).Conclusions: In over half of cases, antifibrotic choice was patient-led. Avoiding the need to wear sunscreen (nintedanib) and diarrhoea (pirfenidone) were the common reasons stated for choice. Physician-led choice was predominantly due to relative contraindications.FootnotesCite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA2953.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).