特发性肺纤维化患者抗纤维化治疗的耐受性和疗效:一项真实世界研究的结果

IF 3.3 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Ruiming Zhao , Bingbing Xie , Xin Wang , Xinran Zhang , Yanhong Ren , Chen Wang , Huaping Dai
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引用次数: 0

摘要

背景特发性肺纤维化是一种进展性致命肺病,缺乏有效的治疗方法。建议患者使用吡非尼酮或宁替尼治疗,以延缓疾病的进展。本研究旨在调查吡非尼酮和宁替尼在特发性肺纤维化患者中的临床应用、不良反应、耐受性以及抗纤维化治疗的疗效。方法我们招募了2017年2月至2022年2月在中日友好医院接受吡非尼酮或宁替尼治疗的特发性肺纤维化患者。我们调查了患者的用药情况、不良反应、耐受性和服药后的存活率。结果共有303名特发性肺纤维化患者纳入研究。205名患者接受吡非尼酮治疗,98名患者接受宁替达尼治疗。两组患者的基线数据无明显差异。接受宁替尼治疗的患者的总体停药率高于接受吡非尼酮治疗的患者(61.22% vs. 32.68%,p <0.001)。在所有患者组中,最常见的停药原因是与药物相关的不良反应。与吡非尼酮相比,宁替尼因不良反应导致的停药率明显更高(48.98% vs 27.80%,p <0.001)。两种药物最常见的副作用都是腹泻。与宁替尼相比,吡非尼酮的消化道外不良反应发生率更高。两种药物的存活率无明显差异,使用超过1200毫克/天的吡非尼酮并不能显著提高存活率。结论胃肠道不良反应是最常见的不良反应,也是停用抗纤维化治疗尤其是宁替尼的主要原因。坚持抗纤维化治疗可使患者从调整抗纤维化药物、剂量和积极控制副作用中获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The tolerability and efficacy of antifibrotic therapy in patients with idiopathic pulmonary fibrosis: Results from a real-world study

Background

Idiopathic pulmonary fibrosis is a progressive and fatal lung disease lacking effective therapeutics. Treatment with pirfenidone or nintedanib is recommended for patients to delay the progression of their disease. Adverse reactions caused by anti-fibrosis drugs can sometimes interrupt treatment and even change the progression of the disease.

Objective

This study aimed to investigate the clinical use, adverse reactions, tolerability of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis and the efficacy of antifibrotic therapy in a real world.

Methods

We recruited patients with idiopathic pulmonary fibrosis treated with pirfenidone or nintedanib at China-Japan Friendship Hospital from February 2017 to February 2022. We investigated the medication situation, adverse reactions, tolerability and survival of patients taking medications.

Results

A total of 303 patients with idiopathic pulmonary fibrosis were enrolled in the study. Treatment was divided between 205 patients receiving pirfenidone and 98 patients receiving nintedanib. Baseline data between the two groups were not significantly different. Patients treated with nintedanib had a higher overall discontinuation rate than those treated with pirfenidone (61.22 vs. 32.68 %, p < 0.001). Across all patient groups, the most common reason for discontinuing treatment was medication-related adverse effects. Compared to pirfenidone, nintedanib had a significantly higher discontinuation rate due to adverse events (48.98 % vs 27.80 %, p < 0.001). The most common side effect of both drugs was diarrhea. Pirfenidone was associated with a higher rate of extra-digestive adverse effects than nintedanib. Survival was not significantly different between the two drugs and using pirfenidone above 1200 mg/day did not confer significant survival benefits. The survival rate of patients who adhere to anti-fibrosis therapy for more than 6 months can be significantly improved (HR = 0.323, p = 0.0015).

Conclusion

Gastrointestinal adverse effects were the most common adverse effects and the main reason of discontinuation of antifibrotic therapy, especially nintedanib. Consistent adherence to antifibrotic therapy may make the patients benefit from adjusting their antifibrotic medications, dosage, and active management of side effects.

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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
41
审稿时长
42 days
期刊介绍: Pulmonary Pharmacology and Therapeutics (formerly Pulmonary Pharmacology) is concerned with lung pharmacology from molecular to clinical aspects. The subject matter encompasses the major diseases of the lung including asthma, cystic fibrosis, pulmonary circulation, ARDS, carcinoma, bronchitis, emphysema and drug delivery. Laboratory and clinical research on man and animals will be considered including studies related to chemotherapy of cancer, tuberculosis and infection. In addition to original research papers the journal will include review articles and book reviews. Research Areas Include: • All major diseases of the lung • Physiology • Pathology • Drug delivery • Metabolism • Pulmonary Toxicology.
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