Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis

Wencel, Mark; Limb, Susan L.; Stauffer, John L.; Morgenthien, Elizabeth; Raimundo, Karina; LaCamera, Peter

doi:10.1007/s41030-018-0056-8

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…When queried regarding the most important factors when deciding to implement an alternative titration schedule for pirfenidone, respondents indicated that gastrointestinal intolerance was the most important factor, followed by liver enzyme elevations and patient comorbidities. 25…”

Section: Discussionmentioning

confidence: 99%

“…An online, self-administered, 30-minute survey (Supplemental File 1) was developed by experts in the fields of medicine, epidemiology, health economics, and psychometrics—which was described previously. 25 More than 400 interstitial lung disease (ILD) experts were contacted based on their participation in the Pulmonary Fibrosis Foundation (PFF) Care Center Network. 26 These experts were identified based on the PFF’s experience in collaborating with leading medical centers in the United States to fund IPF research and improve patient care.…”

Section: Methodsmentioning

confidence: 99%

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Physician characteristics associated with treatment initiation patterns in idiopathic pulmonary fibrosis

LaCamera

Limb²,

Morgenthien³

et al. 2019

Chron Respir Dis

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Pirfenidone and nintedanib are oral antifibrotic agents approved for the treatment of idiopathic pulmonary fibrosis (IPF). Real-world data on factors that influence IPF treatment decisions are limited. Physician characteristics associated with antifibrotic therapy initiation following an IPF diagnosis were examined in a sample of US pulmonologists. An online, self-administered survey was fielded to pulmonologists between April 10, 2017, and May 17, 2017. Pulmonologists were included if they spent >20% of their time in direct patient care and had ≥5 patients with IPF receiving antifibrotics. Participants answered questions regarding timing and reasons for considering the initiation of antifibrotic therapy after an IPF diagnosis. A total of 169 pulmonologists participated. The majority (81.7%) considered initiating antifibrotic therapy immediately after IPF diagnosis all or most of the time (immediate group), while 18.3% considered it only some of the time or not at all (delayed group). Pulmonologists in the immediate group were more likely to work in private practice (26.1%), have a greater mean percentage of patients receiving antifibrotic therapy (60.8%), and decide to initiate treatment themselves (31.2%) versus those in the delayed group (16.1%, 30.5%, and 16.1%, respectively). Most pulmonologists consider initiating antifibrotic treatment immediately after establishing an IPF diagnosis all or most of the time versus using a “watch-and-wait” approach. Distinguishing characteristics between pulmonologists in the immediate group versus the delayed group included practice setting, percentage of patients receiving antifibrotic therapy, and the decision-making dynamics between the patient and the pulmonologist.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Physician characteristics associated with treatment initiation patterns in idiopathic pulmonary fibrosis

LaCamera

Limb²,

Morgenthien³

et al. 2019

Chron Respir Dis

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“…Nintedanib and pirfenidone have been approved to be used to treat pulmonary fibrosis, yet they have serious diverse reactions (such as gastrointestinal symptoms, photosensitivity, and abnormal liver function) [7][8][9][10]. Such phenomenon may be ascribed to the complicated regulatory networks involved in pulmonary fibrosis, which suppress or promote associated target genes or pathway expression [11][12][13]. It is increasingly suggested that epigenetic, genetic, or proteomic factors play important roles in these regulatory networks in pulmonary fibrosis [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Mechanism of Fei-Xian Formula in the Treatment of Pulmonary Fibrosis on the Basis of Network Pharmacology Analysis Combined with Molecular Docking Validation

Chen

Tang

Xiao

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. This study aimed to clarify the mechanism of Fei-Xian formula (FXF) in the treatment of pulmonary fibrosis based on network pharmacology analysis combined with molecular docking validation. Methods. Firstly, ingredients in FXF with pharmacological activities, together with specific targets, were identified based on the BATMA-TCM and TCMSP databases. Then, targets associated with pulmonary fibrosis, which included pathogenic targets as well as those known therapeutic targets, were screened against the CTD, TTD, GeneCards, and DisGeNet databases. Later, Cytoscape was employed to construct a candidate component-target network of FXF for treating pulmonary fibrosis. In addition, for nodes within the as-constructed network, topological parameters were calculated using CytoHubba plug-in, and the degree value (twice as high as the median degree value for all the nodes) was adopted to select core components as well as core targets of FXF for treating pulmonary fibrosis, which were subsequently utilized for constructing the core network. Furthermore, molecular docking study was carried out on those core active ingredients together with the core targets using AutoDock Vina for verifying results of network pharmacology analysis. At last, OmicShare was employed for enrichment analysis of the core targets. Results. Altogether 12 active ingredients along with 13 core targets were identified from our constructed core component-target network of FXF for the treatment of pulmonary fibrosis. As revealed by enrichment analysis, the 13 core targets mostly concentrated in regulating biological functions, like response to external stimulus (from oxidative stress, radiation, UV, chemical substances, and virus infection), apoptosis, cell cycle, aging, immune process, and protein metabolism. In addition, several pathways, like IL-17, AGE-RAGE, TNF, HIF-1, PI3K-AKT, NOD-like receptor, T/B cell receptor, and virus infection-related pathways, exerted vital parts in FXF in the treatment of pulmonary fibrosis. Conclusions. FXF can treat pulmonary fibrosis through a “multicomponent, multitarget, and multipathway” mean. Findings in this work lay foundation for further exploration of the FXF mechanism in the treatment of pulmonary fibrosis.

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confidence: 99%

“…Different factors associated with digestion and absorption could be involved in the incidence of pirfenidone GI AEs, such as the type of food and drug intake, patient age and gastro-oesophageal reflux [12][13][14][15]. Several approaches for preventing and managing potential pirfenidone-related GI AEs in patients with IPF include: dose escalation schedules, adjusting pirfenidone dose to patient weight, and pirfenidone administration at mealtimes [13][14][15]. In the present study, the protocol regarding drug intake during meals and dose adjustment was the same across centres, and no significant differences were found in patient age or the prevalence of gastro-oesophageal reflux among countries.…”

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confidence: 99%

Gastrointestinal pirfenidone adverse events in idiopathic pulmonary fibrosis depending on diet: the MADIET clinical trial

Molina-Molina,

Shull,

Vicens-Zygmunt

et al. 2023

Eur Respir J

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Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis

Cited by 4 publications

References 19 publications

Physician characteristics associated with treatment initiation patterns in idiopathic pulmonary fibrosis

Physician characteristics associated with treatment initiation patterns in idiopathic pulmonary fibrosis

Mechanism of Fei-Xian Formula in the Treatment of Pulmonary Fibrosis on the Basis of Network Pharmacology Analysis Combined with Molecular Docking Validation

Gastrointestinal pirfenidone adverse events in idiopathic pulmonary fibrosis depending on diet: the MADIET clinical trial

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