Abstract
<b>Background:</b> Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic interstitial lung disease of largely unknown cause. Management of IPF has changed drastically with the licensing of 2 anti-fibrotics. <b>Aim:</b> To study the real-life experience of our IPF patients on Pirfenidone vs Nintedanib. <b>Method:</b> All IPF patients commenced on Pirfenidone and Nintedanib from January 2017 to January 2020 were recruited (108 included). Demographics, date of treatment initiation, side-effects(SE), dosages and pulmonary function test pre- and 6 months post-treatment were collected. <b>Results:</b> Patient mean age was 75.1±7.2 years. Male to female ratio 2.6. There was equal split between the two treatments. Pirfenidone was more likely to cause all SE, 50.0% vs 28.6% (P value= 0.0299).The mean decline in FVC and DLCO at 6 months appeared greater in the Nintedanib group however this was not statistically significant. The same observation was made when we directly compared reduced dose of anti-fibrotics with each other. There was no difference in patient survival between the two treatments at 18 months. <b>Conclusion:</b> Nintedanib was better tolerated in our cohort leading to less treatment reduction and discontinuation. It was not inferior in preserving lung function. Study limitations include low numbers of patients especially in the reduced dose group.
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