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A Study of Tolerability and Therapeutic Effect of Antifibrotic Agents for Elderly Patients with Idiopathic Pulmonary Fibrosis
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A1632 - A Study of Tolerability and Therapeutic Effect of Antifibrotic Agents for Elderly Patients with Idiopathic Pulmonary Fibrosis
Author Block: T. Sawata; Toho University, Ootaku, Japan.
Background and objective The objective is to demonstrate the tolerability and therapeutic effect of antifibrotic agents for idiopathic pulmonary fibrosis (IPF) patients 75 years of age or older. Patients and method We retrospectively evaluated the tolerability and therapeutic effect for 69 IPF patients 75 years of age or older who received antifibrotic agents for IPF in our institution between April 2007 and June 2017. Results Pirfenidone (P) was administered to 52 patients (40 males, 12 females, age 81.6 ± 5.9),Japanese IPF disease severity stage I = 7; II = 5; III = 19; IV = 21. Nintedanib (N) was administered to 17 patients (14 male, 3 female, age 81.4 ± 4.9), disease severity stage I = 2; II = 1; III = 5; IV = 9; there was a high ratio of Grade III and above. The median duration of treatment was 183 days for P, and 91 days for N. Adverse events occurred in 46 patients (88.4%) of P, and 16 patients (94.1%) of N, of which treatment was discontinued in 32 patients (69.6%) using P (anorexia = 23, disease progression = 9); and in 13 patients (93.8%) using N (anorexia / diarrhea = 9, disease progression = 4). Patients who continued treatment for 52 weeks or more were 8 (15.4%) with P, average ΔFVC = -125 ± 243 mL; 1 patient (5.9%) with N, average ΔFVC = 24.4 ± 83.2mL; and compared with patients discontinuing treatment within 52 weeks, patients with P had significantly lower cardiac disease prevalence (12.5% vs. 70.5%; p =0.04), and tended to have higher BMI (23.4 ± 13.2 vs. 17.4 ± 4.4; p =0.098), while there were no significant differences in patients with N. Conclusions Antifibrotic agents had low tolerability in elderly patients. Considering the relationship between efficacy and safety, it is important to carefully select target patients.
Author Block: T. Sawata; Toho University, Ootaku, Japan.
Background and objective The objective is to demonstrate the tolerability and therapeutic effect of antifibrotic agents for idiopathic pulmonary fibrosis (IPF) patients 75 years of age or older. Patients and method We retrospectively evaluated the tolerability and therapeutic effect for 69 IPF patients 75 years of age or older who received antifibrotic agents for IPF in our institution between April 2007 and June 2017. Results Pirfenidone (P) was administered to 52 patients (40 males, 12 females, age 81.6 ± 5.9),Japanese IPF disease severity stage I = 7; II = 5; III = 19; IV = 21. Nintedanib (N) was administered to 17 patients (14 male, 3 female, age 81.4 ± 4.9), disease severity stage I = 2; II = 1; III = 5; IV = 9; there was a high ratio of Grade III and above. The median duration of treatment was 183 days for P, and 91 days for N. Adverse events occurred in 46 patients (88.4%) of P, and 16 patients (94.1%) of N, of which treatment was discontinued in 32 patients (69.6%) using P (anorexia = 23, disease progression = 9); and in 13 patients (93.8%) using N (anorexia / diarrhea = 9, disease progression = 4). Patients who continued treatment for 52 weeks or more were 8 (15.4%) with P, average ΔFVC = -125 ± 243 mL; 1 patient (5.9%) with N, average ΔFVC = 24.4 ± 83.2mL; and compared with patients discontinuing treatment within 52 weeks, patients with P had significantly lower cardiac disease prevalence (12.5% vs. 70.5%; p =0.04), and tended to have higher BMI (23.4 ± 13.2 vs. 17.4 ± 4.4; p =0.098), while there were no significant differences in patients with N. Conclusions Antifibrotic agents had low tolerability in elderly patients. Considering the relationship between efficacy and safety, it is important to carefully select target patients.
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