Page 65 - 81_04

ANALES?DE?LA?REAL?ACADEMIA?NACIONAL?DE?FARMACIA? Short Communication

ISSN (Online) 1697-4298 analesranf.com

Pirfenidone experience in mild-to-moderate idiopathic pulmonary
fibrosis in a general hospital

Title in Spanish: Experiencia con pirfenidona en fibrosis pulmonar idiopática leve-moderada en un hospital
general

Javier Martínez-Moreno1*, José Manuel Ventura-Cerdá1, Alfonso Ángel López Navarro1, Ana Cristina
Cercos Lletí1, Susana Herrera Lara2, Mónica Climente Marti1

1Servicio de Farmacia. Hospital Universitario Dr. Peset. 2Servicio de neumología. Hospital Universitario Dr. Peset

ABSTRACT: This article present the experience and RESUMEN: Este artículo presenta la experiencia y los

outcomes of patients treated with pirfenidone. FVC and resultados de pacientes tratados con pirfenidona. Se
DLCO parameters during 12 months were collected in obtuvieron parámetros de FVC y DLCO durante 12

patients treated with pirfenidone. Eight of the ten meses en pacientes tratados con pirfenidona. Ocho de
patients continued treatment until month 12. 7 patients los diez pacientes continuaron el tratamiento hasta el
presented at 12 months an adequate response treatment, mes 12. 7 pacientes presentaron a los 12 meses un

1 patient did not achieve therapeutic targets established tratamiento de respuesta adecuada, 1 paciente no logró
(improvement or stability). At week 52, our patients had objetivos terapéuticos establecidos (mejoría o
a mean of change in FVC(%) of -2.38±6.93%; patients estabilidad). En la semana 52, nuestros pacientes tenían

of clinical trials showed -5.2% and -8.3% treated with una media de cambio en FVC(%) de - 2.38±6.93%; los
pirfenidone and placebo respectively. Higher incidence pacientes de los ensayos clínicos demostraron-5.2% y-
of adverse effects was observed than clinical trials. Our 8.3% tratados con pirfenidona y placebo

results show that pirfenidone is a well-tolerated drug, respectivamente. Se observó mayor incidencia de
whose toxicity can be controlled by dose adjustment, efectos adversos de los ensayos clínicos. Nuestros
and it is effective in mild-moderate IPF. Due to no resultados muestran que pirfenidona es un fármaco bien
proven effectiveness and safety in medium / long term tolerado, cuya toxicidad puede ser controlada mediante

and the high economic impact, it is necessary to identify el ajuste de la dosis, y es eficaz en IPF de leve a
those patients who may get more clinical benefits. moderada. Debido a la no probada eficacia y seguridad a
medio/largo plazo y alto impacto económico, es

necesario identificar a aquellos pacientes que pueden
obtener mayores beneficios clínicos.

*Corresponding Author: e-mail: javigarvi@gmail.com An Real Acad Farm Vol. 81, Nº 4 (2015), pp. 334-337
Received: December 24, 2015 Accepted: February 4, 2016 Language of Manuscript: English

1. BACKGROUND fatigue, eosinophilia, clubbing and increased acute phase
reactants.
Idiopathic pulmonary fibrosis (IPF) is an interstitial
chronic pulmonary disease, which affect patients older There is no clear consensus about patients’
than 50 years old. Disease aetiology is unknown, but has classification. The mild, moderate and severe terms are
been associated with risk factors such as tobacco used depending on symptoms and function tests, although
consumption, viral infections, environmental pollution, only mild-to-moderate IPF has been characterized (Forced
drug and genetic predisposition (1-2). Estimated incidence Vital Capacity (FVC) =50%, Diffusion of Carbon Dioxide
varies between 7 and 16 cases/100000 inhabitants/year, (DLCO) =35% (6)). Despite the mild diagnosis, medium-
with a prevalence ranging between 14 and 43 term prognosis is poor, with a median survival between
cases/100000 inhabitants (3). two and four years after diagnosis. Respiratory failure is
the most common cause of death (40%). Other causes of
IPF is characterized by an abnormal histopathological death in patients with IPF include heart failure, ischemic
mesenchymal cell proliferation, fibrosis, overproduction heart disease, infection, and pulmonary embolism. Age
and disorganized collagen deposition, extracellular matrix under 50 years, female gender, preserved lung function
changes with distortion of pulmonary architecture and and increased proportion of lymphocytes (20-25%) in
appearance of subpleural cysts (honeycomb cysts), with bronchoalveolar fluid have been associated with more
accumulation of myofibroblast and fibroblast (3-5). In survival (7). Age over 70 years, Comorbidities (pulmonary
early stages, clinical pattern is similar to other lung hypertension), emphysema and lung cancer), DLCO under
diseases; signs and symptoms is unproductive cough, 40%, FVC decrease=10% and DLCO decrease=15%

334 @Real Academia Nacional de Farmacia. Spain