Comparative study between pirfenidone and traditional drugs in treatment of idiopathic pulmonary fibrosis

Abstract

Background Idiopathic pulmonary fibrosis (IPF) is a specific fibrosing form of interstitial pneumonia that is chronic, progressive and of an unknown etiology. IPF was initially considered to be an inflammation-driven disorder. Therefore, early treatment is aimed to eliminate or suppress the inflammatory process. Pirfenidone is the first antifibrotic drug used in the treatment of IPF. The approval of pirfenidone in 2008 gave us the hope for a new era in the treatment of this aggressive disease. Aim The aim of the study is to assess the efficiency and safety of pirfenidone in a group of patients with IPF. Patients and methods This study included 40 adult patients with IPF. Patients were divided into two groups. Group A included 20 patients who accepted to start pirfenidone treatment. There were 13 females and seven males. Their mean age was 57.1±8.19 years. Group B included 20 sex-matched (13 females and seven males) and age-matched (57.25±8.05 years) patients starting conventional treatment for IPF (systemic steroids and azathioprine). Results Mean decline in predicted forced vital capacity was −0.89±14.55% for group A and −5.48±10.89% for group B, with no statistical significant. Oxygen saturation improved slightly in group A, but with no statistical significant differences between two groups (P>0.05). There was progression of the disease according to high-resolution computed tomography in 60% in group A and 70% in group B, stationary in 30% in group A and 30% in group B, whereas only 10% in group A showed regression of the disease. Conclusion Pirfenidone improved distance walked in 6-min walk test and exercise oxygen saturation in patients with IPF, improved PaO2 in treatment group after 3 months therapy, and has good effect on radiological presentation of patients with IPF compared with steroids with azathioprine.