PT  - JOURNAL ARTICLE
AU  - Raats- ten Cate, Ivonne M.
AU  - Van Moorsel, Coline H M
AU  - Van Der Meer, Akke-Nynke
AU  - Zanen, Pieter
AU  - Grutters, Jan C
TI  - Efficacy of switching antifibrotic therapy in idiopathic pulmonary fibrosis: real life data
AID  - 10.1183/13993003.congress-2019.PA1727
DP  - 2019 Sep 28
TA  - European Respiratory Journal
PG  - PA1727
VI  - 54
IP  - suppl 63
4099  - http://erj.ersjournals.com/content/54/suppl_63/PA1727.short
4100  - http://erj.ersjournals.com/content/54/suppl_63/PA1727.full
SO  - Eur Respir J2019 Sep 28; 54
AB  - Introduction: In idiopathic pulmonary fibrosis (IPF) pirfenidone and nintedanib slow disease progression. However, some patients experience unchanged disease progression or unmanageable side effects due to treatment. Case reports suggest that switching from one drug to the other may preserve lung function in patients with IPF.Aim: To investigate evolution of lung function after switching from pirfenidone to nintedanib due to clinical progression or severe side effects.Method: Patients with IPF who started on pirfenidone and switched to nintedanib between 2014-2018 were registered in the RedCap database. FVC, DLco and side effects were collected from medical records. Changes in lung function were assessed with random slope/intercept mixed models analysis.Results: 90 patients on pirfenidon (67 +/-10 yr, 77% men) were included of whom 68% switched to nintedanib due to side effects and 32% due to disease progression. Before start of pirfenidone the mean change in FVC was -210 ml or -5,6% of predicted per year and for DLco -0.42mmol/min/kPa or -4.9% of predicted per year. An equal rate of decline was found during the pirfenidone and the nintedanib treatment periods (p=0.734 resp. p=0.621 for change in trends). However, a significant decrease of DLCO (-1,7% predicted) was observed at the moment of switching from pirfenidone to nintedanib.Conclusion: The present study shows that trend in lung function decline is not influenced by switching pirfenidone to nintedanib in patients with IPF. This suggests that one should be tentative of switching antifibrotic therapy especially in case of disease progression.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA1727.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).