Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis
Abstract Introduction Pirfenidone is an oral antifibrotic agent approved for idiopathic pulmonary fibrosis (IPF). Real-world data on adverse event (AE) management for pirfenidone are limited. Strategies for managing potential antifibrotic therapy AEs were examined in a sample of US pulmonologists. M...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2018-06-01
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| Series: | Pulmonary Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s41030-018-0056-8 |
| _version_ | 1797219677251829760 |
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| author | Mark L. Wencel Tmirah Haselkorn Susan L. Limb John L. Stauffer Elizabeth Morgenthien Karina Raimundo Peter P. LaCamera |
| author_facet | Mark L. Wencel Tmirah Haselkorn Susan L. Limb John L. Stauffer Elizabeth Morgenthien Karina Raimundo Peter P. LaCamera |
| author_sort | Mark L. Wencel |
| collection | DOAJ |
| description | Abstract Introduction Pirfenidone is an oral antifibrotic agent approved for idiopathic pulmonary fibrosis (IPF). Real-world data on adverse event (AE) management for pirfenidone are limited. Strategies for managing potential antifibrotic therapy AEs were examined in a sample of US pulmonologists. Methods An online, self-administered survey was fielded to pulmonologists between April 10 and May 17, 2017. Pulmonologists were included if they spent > 20% of their time in direct patient care and had ≥ 5 patients with IPF on antifibrotic therapy. Participants answered questions regarding initiation of pirfenidone, dose titration, and management of potential AEs. Results A total of 169 pulmonologists participated. Gastrointestinal (GI) intolerance was the most important factor in implementing alternative titration schedules for pirfenidone. Approximately three-quarters of pulmonologists recommended the standard titration scheme for starting treatment; however, a range of titration schedules up to 8 weeks were described, with a 4-week schedule being most common. Pulmonologists reported that most patients treated with alternative titration schedules could achieve the full dose of pirfenidone. Pulmonologists who were most effective at mitigating pirfenidone-related GI AEs by advising dosing at mealtimes more frequently recommended taking pirfenidone during a substantial meal than pulmonologists who were less effective. For photosensitivity AEs, pulmonologists recommended sunscreen use, sun avoidance, wearing a hat, and ultraviolet protection factor clothing. Conclusions Pulmonologists reported that alternative titration schedules for initiating pirfenidone were common and can aid in maintaining the full dose. Proposed strategies to ameliorate pirfenidone-related GI and photosensitivity AEs included taking pirfenidone during a substantial meal and minimizing sun exposure, respectively. Funding F. Hoffmann-La Roche Ltd./Genentech, Inc. Plain Language Summary Plain language summary available for this article. |
| first_indexed | 2024-04-24T12:37:27Z |
| format | Article |
| id | doaj.art-8e4e70d7838741dd9dd5a36d9d982098 |
| institution | Directory Open Access Journal |
| issn | 2364-1754 2364-1746 |
| language | English |
| last_indexed | 2024-04-24T12:37:27Z |
| publishDate | 2018-06-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Pulmonary Therapy |
| spelling | doaj.art-8e4e70d7838741dd9dd5a36d9d9820982024-04-07T11:26:27ZengAdis, Springer HealthcarePulmonary Therapy2364-17542364-17462018-06-014110311410.1007/s41030-018-0056-8Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary FibrosisMark L. Wencel0Tmirah Haselkorn1Susan L. Limb2John L. Stauffer3Elizabeth Morgenthien4Karina Raimundo5Peter P. LaCamera6Via Christi HealthEpiMetrix, Inc.Genentech, Inc.Genentech, Inc.Genentech, Inc.Genentech, Inc.St. Elizabeth’s Medical CenterAbstract Introduction Pirfenidone is an oral antifibrotic agent approved for idiopathic pulmonary fibrosis (IPF). Real-world data on adverse event (AE) management for pirfenidone are limited. Strategies for managing potential antifibrotic therapy AEs were examined in a sample of US pulmonologists. Methods An online, self-administered survey was fielded to pulmonologists between April 10 and May 17, 2017. Pulmonologists were included if they spent > 20% of their time in direct patient care and had ≥ 5 patients with IPF on antifibrotic therapy. Participants answered questions regarding initiation of pirfenidone, dose titration, and management of potential AEs. Results A total of 169 pulmonologists participated. Gastrointestinal (GI) intolerance was the most important factor in implementing alternative titration schedules for pirfenidone. Approximately three-quarters of pulmonologists recommended the standard titration scheme for starting treatment; however, a range of titration schedules up to 8 weeks were described, with a 4-week schedule being most common. Pulmonologists reported that most patients treated with alternative titration schedules could achieve the full dose of pirfenidone. Pulmonologists who were most effective at mitigating pirfenidone-related GI AEs by advising dosing at mealtimes more frequently recommended taking pirfenidone during a substantial meal than pulmonologists who were less effective. For photosensitivity AEs, pulmonologists recommended sunscreen use, sun avoidance, wearing a hat, and ultraviolet protection factor clothing. Conclusions Pulmonologists reported that alternative titration schedules for initiating pirfenidone were common and can aid in maintaining the full dose. Proposed strategies to ameliorate pirfenidone-related GI and photosensitivity AEs included taking pirfenidone during a substantial meal and minimizing sun exposure, respectively. Funding F. Hoffmann-La Roche Ltd./Genentech, Inc. Plain Language Summary Plain language summary available for this article.https://doi.org/10.1007/s41030-018-0056-8Adverse event managementAntifibrotic therapyIdiopathic pulmonary fibrosisPirfenidoneReal-worldTitration |
| spellingShingle | Mark L. Wencel Tmirah Haselkorn Susan L. Limb John L. Stauffer Elizabeth Morgenthien Karina Raimundo Peter P. LaCamera Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis Pulmonary Therapy Adverse event management Antifibrotic therapy Idiopathic pulmonary fibrosis Pirfenidone Real-world Titration |
| title | Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis |
| title_full | Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis |
| title_fullStr | Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis |
| title_full_unstemmed | Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis |
| title_short | Real-World Practice Patterns for Prevention and Management of Potential Adverse Events with Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis |
| title_sort | real world practice patterns for prevention and management of potential adverse events with pirfenidone in patients with idiopathic pulmonary fibrosis |
| topic | Adverse event management Antifibrotic therapy Idiopathic pulmonary fibrosis Pirfenidone Real-world Titration |
| url | https://doi.org/10.1007/s41030-018-0056-8 |
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