Pneumologie 2017; 71(S 01): S1-S125
DOI: 10.1055/s-0037-1598501
Posterbegehung – Sektion Klinische Pneumologie
Interstitielle Lungenerkrankungen – Ulrich Costabel/Essen, Lars Hagmeyer/Solingen
Georg Thieme Verlag KG Stuttgart · New York

Benefit of treatment with pirfenidone (PFD) persists over time in patients with idiopathic pulmonary fibrosis (IPF) with limited lung function impairment

U Costabel
1   Interstitielle und Seltene Lungenkrankheiten, Interstitial and Rare Lung Disease Unit, Ruhrlandklinik
,
PW Noble
2   Cedars-Sinai Medical Center
,
C Albera
3   University of Torino
,
KU Kirchgaessler
4   Roche
,
F Gilberg
4   Roche
,
U Petzinger
5   Accovion GmbH
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2017 (online)

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Background:

Antifibrotic therapy for IPF is often started when lung function has declined below certain levels, such as 80% predicted FVC or when GAP stage II is reached. Long-term benefits of therapy when lung function is still relatively well preserved, compared with delayed intervention, are unknown.

Objective:

To assess the benefit of early treatment with PFD.

Methods:

Patients in RECAP, a long-term extension study of the CAPACITY (CAP) trials, who entered CAP-004 in GAP stage I and received PFD 2403 mg/d were compared with those in GAP stage I who initially received placebo and then switched to PFD 2403 mg/d in RECAP. Annual rate of change in FVC and safety and tolerability of PFD were assessed.

Results:

144 patients in CAP-004 in GAP stage I entered RECAP; 71 initially received PFD 2403 mg/d and 73 received placebo for ≈1.5 y. Prior to RECAP, PFD-treated patients had an annual rate of decline of 3.4% (SE, 0.61) and placebo patients had an annual rate of decline of 5.2% (SE, 0.60). When entering RECAP, PFD- and placebo-treated patients had a baseline mean % predicted FVC of 75.4% vs. 76.3%, respectively. During RECAP, both groups declined similarly over 180 wk, with an annual rate of decline of 4.5% (SE = 0.486) and 3.9% (SE = 0.473; P= 0.440). Safety and tolerability of PFD were similar in both groups.

Conclusions:

Patients with IPF in GAP I stage may benefit from early treatment with PFD, as the reduction in decline with treatment is maintained over 180 wk. This supports treatment initiation irrespective of GAP stage.