RT Journal Article
SR Electronic
T1 Antifibrotic choice in idiopathic pulmonary fibrosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2953
DO 10.1183/13993003.congress-2018.PA2953
VO 52
IS suppl 62
A1 Hayton, Conal
A1 Morris, Helen
A1 Marshall, Tracey
A1 Zakis, Katie
A1 Garfoot, Theresa
A1 Rivera Ortega, Pilar
A1 Greaves, Melanie
A1 Leonard, Colm
A1 Chaudhuri, Nazia
YR 2018
UL http://erj.ersjournals.com/content/52/suppl_62/PA2953.abstract
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).