CT analysis of the effect of pirfenidone in patients with idiopathic pulmonary fibrosis

Iwasawa, Tae; Ogura, Takashi; Sakai, Fumikazu; Kanauchi, Tetsu; Komagata, Takanobu; Baba, Tomohisa; Gotoh, Toshiyuki; Morita, Satoshi; Yazawa, Takuya; Inoue, Tomio

doi:10.1016/j.ejrad.2012.02.014

Cited by 69 publications

(56 citation statements)

References 17 publications

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“…Iwashita et al reported that the radiological findings have improved in only 3 of the 38 cases 1 year after pirfenidone initiation [19], which is consistent to our result. However, our investigation showed that radiologic improvement could be observed in shorter treatment periods, 3-6 months after pirfenidone initiation.…”

Section: Discussionsupporting

confidence: 83%

Predictors of the clinical effects of pirfenidone on idiopathic pulmonary fibrosis

Arai

Inoue

Sasaki

et al. 2014

Respiratory Investigation

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Section: Discussionsupporting

confidence: 83%

Predictors of the clinical effects of pirfenidone on idiopathic pulmonary fibrosis

Arai

Inoue

Sasaki

et al. 2014

Respiratory Investigation

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“…1G, H), the fibrotic changes in our case were consistent with relatively typical chronic progression of IPF (13). Sequential changes on HRCT have not been sufficiently evaluated with respect to the efficacy of pirfenidone in most past trials (14). Presently, FVC is the most widely adopted index for assessing disease progression in cases of IPF.…”

Section: Discussionmentioning

confidence: 99%

Marked Improvement with Pirfenidone in a Patient with Idiopathic Pulmonary Fibrosis

et al. 2016

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A man in his mid-60's with idiopathic pulmonary fibrosis and hepatitis B-related liver cirrhosis developed exertional dyspnea and a dry cough lasting for three months. High-resolution computed tomography (HRCT) showed increasing bilateral ground-glass opacity superimposed on the usual interstitial pneumonia pattern. Six months after starting pirfenidone therapy, the partial pressure of arterial oxygen at rest increased from 81 to 101 torr, the predicted forced vital capacity (FVC) value increased from 75% to 94% and the ground-glass opacity on HRCT improved. The FVC value was subsequently maintained near or above baseline for 43 months. We concluded that our patient was a super-responder to pirfenidone therapy.

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“…In the absence of new or worsening symptoms, HRCT is not usually obtained for routine follow-up, despite its ability to provide an accurate anatomical assessment of the extent and severity of findings. It is unclear what incremental data HRCT provides over routine PFTs, particularly given that agreement between HRCT and PFT changes over time is moderate at best [48,49].…”

Section: Prognosismentioning

confidence: 99%

“…While typical endpoints in clinical trials include morality, declines in FVC and incidence of acute exacerbations [54,55], HRCT is currently being utilised as an endpoint in multiple ongoing clinical drug trials with an emphasis on IPF patients. As an example, the ability of pirfenidone to slow the progression of fibrosis in treated IPF patients was recently confirmed using visual scores and quantitative analysis of HRCT images [49].…”

Section: Detection Of Disease Progression In Patients With Worsening mentioning

confidence: 99%

The role of high-resolution computed tomography in the follow-up of diffuse lung disease

2017

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High-resolution computed tomography (HRCT) of the lung is a key component of the multidisciplinary approach to diagnosis in diffuse lung disease (DLD). HRCT also plays an important role in the follow-up of patients with established DLD. In this respect, serial HRCT examinations may provide valuable information that cannot be determined from clinical history and other diagnostic tests, such as pulmonary function tests. Important roles of HRCT in this context include assisting in determining prognosis, monitoring for the efficacy of treatment, detecting progression of disease or complications, and evaluating patients with worsening or acute symptoms. Both clinicians and radiologists should be aware of the expected evolution of HRCT changes in a variety of DLDs. The goals of this paper are to discuss: 1) the expected evolution of HRCT findings over time in common DLDs; 2) the role of serial HRCT examinations in formulating an initial diagnosis; and 3) the role of HRCT in the follow-up of patients with known DLD.

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CT analysis of the effect of pirfenidone in patients with idiopathic pulmonary fibrosis

Cited by 69 publications

References 17 publications

Predictors of the clinical effects of pirfenidone on idiopathic pulmonary fibrosis

Predictors of the clinical effects of pirfenidone on idiopathic pulmonary fibrosis

Marked Improvement with Pirfenidone in a Patient with Idiopathic Pulmonary Fibrosis

The role of high-resolution computed tomography in the follow-up of diffuse lung disease

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