Clinical and pharmacological comparison of current antifibrotic drugs for therapy of idiopathic pulmonary fibrosis
https://doi.org/10.18093/0869-0189-2017-27-6-789-802
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Abstract
Therapeutic options for idiopathic pulmonary fibrosis (IPF) have been significantly extended last decade due to clinical use of drugs with confirmed antifibrotic activity, nintedanib and pirfenidone. Results of completed randomized phase III clinical trials (RCT) showed the ability of these drugs to decrease IPF progression and all-cause mortality compared to placebo. No direct comparison of efficacy and safety of different pharmacotherapeutic regimens with nintedanib and pirfenidone in IPF patients was published. The pooled odds ratio for mortality was 0.70 (95% confidential interval (CI), 0.47–1.03) in three trials of nintedanib (INPULSIS-1, INPULSIS-2, and TOMORROW; 2015) and 0.70 (0.47–1.02) in three trials of pirfenidone (CAPACITY-1, CAPACITY-2, and ASCEND). RCTs evaluating clinical efficacy of nintedanib and pirfenidone were not designed to assessment of mortality as the primary end-point; the primary end-point in all the trials was the change in the forced vital capacity of the lungs. Published metaanalyses demonstrated similar effects of nintedanib and pirfenidone on all-cause mortality and mortality from respiratory causes and confirmed favourable effects of both the drugs on course and progression of IPF.
About the Authors
S. K. Zyryanov
Peoples' Friendship University of Russia:
Russian Federation
Russian Federation
Sergey K. Zyryanov, Doctor of Medicine, Professor, Head of Department of General and Clinical Pharmacology, Medical Institute
ul. Miklukho-Maklaya 6, Moscow, 117198, Russia;
O. I. Butranova
Peoples' Friendship University of Russia:
Russian Federation
Russian Federation
Ol'ga I. Butranova, Candidate of Medicine, Assistant Lecturer, Department of General and Clinical Pharmacology, Medical Institute
ul. Miklukho-Maklaya 6, Moscow, 117198, Russia;
O. V. Shatalova
Federal Volgograd State Medical University, Healthcare Ministry of Russia
Russian Federation
Russian Federation
Ol'ga V. Shatalova, Candidate of Medicine, Assistant Lecturer, Department of Clinical Pharmacology and Intensive Care with the Course of Clinical Pharmacology and Clinical Allergology, Faculty of Postgraduate Physician Training
pl. Pavshikh Bortsov 1, Volgograd, 400008, Russia
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For citations:
Zyryanov S.K., Butranova O.I., Shatalova O.V. Clinical and pharmacological comparison of current antifibrotic drugs for therapy of idiopathic pulmonary fibrosis. PULMONOLOGIYA. 2017;27(6):789-802. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-6-789-802
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ISSN 2541-9617 (Online)
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