Pirfenidone in idiopathic pulmonary fibrosis: expert panel discussion on the management of drug-related adverse events

Adv Ther. 2014 Apr;31(4):375-91. doi: 10.1007/s12325-014-0112-1. Epub 2014 Mar 18.

Abstract

Pirfenidone is currently the only approved therapy for idiopathic pulmonary fibrosis, following studies demonstrating that treatment reduces the decline in lung function and improves progression-free survival. Although generally well tolerated, a minority of patients discontinue therapy due to gastrointestinal and skin-related adverse events (AEs). This review summarizes recommendations based on existing guidelines, research evidence, and consensus opinions of expert authors, with the aim of providing practicing physicians with the specific clinical information needed to educate the patient and better manage pirfenidone-related AEs with continued pirfenidone treatment. The main recommendations to help prevent and/or mitigate gastrointestinal and skin-related AEs include taking pirfenidone during (or after) a meal, avoiding sun exposure, wearing protective clothing, and applying a broad-spectrum sunscreen with high ultraviolet (UV) A and UVB protection. These measures can help optimize AE management, which is key to maintaining patients on an optimal treatment dose.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Disease Management
  • Disease-Free Survival
  • Drug-Related Side Effects and Adverse Reactions* / etiology
  • Drug-Related Side Effects and Adverse Reactions* / prevention & control
  • Humans
  • Idiopathic Pulmonary Fibrosis* / diagnosis
  • Idiopathic Pulmonary Fibrosis* / drug therapy
  • Pyridones* / administration & dosage
  • Pyridones* / adverse effects
  • Respiratory Function Tests / methods
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Pyridones
  • Tumor Necrosis Factor-alpha
  • pirfenidone