The effects of pirfenidone in patients with an acute exacerbation of interstitial pneumonia

Clin Respir J. 2018 Apr;12(4):1550-1558. doi: 10.1111/crj.12704. Epub 2017 Sep 27.

Abstract

Introduction: The prognosis of patients with an acute exacerbation of interstitial pneumonia (AE-IP) is poor. Pirfenidone (PFD) reduces the disease progression in idiopathic pulmonary fibrosis.

Objectives: The purpose of this study was evaluating whether the administration of PFD improved the outcomes of AE-IP.

Methods: We conducted a retrospective study of 31 patients with AE-IP who did not recover between 7 and 14 days after an initial treatment. Fourteen patients received PFD within 2 weeks (PFD group) of the AE, while 17 patients were treated without PFD (non-PFD group). The patients' clinical data and computed tomography (CT) scores were analyzed.

Results: The survival rate in the PFD group was not significantly different from non-PFD group at 30 (78.6% vs 64.7%, P = .46) and 90 days (64.3% vs 52.9%, P = .72). The white blood cell counts in the PFD group were significantly lower on PFD day 14 than on PFD days 1 and 7. The C-reactive protein levels in the PFD group were also significantly lower on PFD day 7 than on PFD day 1. There were no significant differences regarding the changes of the CT scores.

Conclusions: PFD may reduce the inflammation in AE-IP patients undergoing corticosteroid treatment.

Keywords: acute exacerbation; computed tomography score; interstitial pneumonia; pirfenidone.

MeSH terms

  • Acute Disease
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Idiopathic Pulmonary Fibrosis / diagnosis
  • Idiopathic Pulmonary Fibrosis / drug therapy*
  • Idiopathic Pulmonary Fibrosis / mortality
  • Japan / epidemiology
  • Male
  • Prognosis
  • Pyridones / administration & dosage*
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Time Factors
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha

Substances

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