Efficacy of pirfenidone vs. placebo in unclassifiable interstitial lung disease, by surgical lung biopsy status: data from a post-hoc analysis
File(s)
Author(s)
Type
Journal Article
Abstract
Approximately 12-13% of patients with interstitial lung disease (ILD) are diagnosed with unclassifiable ILD (uILD), often despite thorough evaluation. A recent Phase 2 study (NCT03099187) described a significant effect of pirfenidone vs. placebo on forced vital capacity (FVC) measured by site spirometry in patients with progressive fibrosing uILD (hereafter referred to as the pirfenidone in uILD study). Here, we present the results from a post-hoc analysis of this study to assess patient baseline characteristics and the efficacy of pirfenidone vs. placebo analyzed by surgical lung biopsy (SLB) status. Mean FVC (mL) change over 24 weeks was included as a post-hoc efficacy outcome. Of 253 randomized patients, 88 (34.8%) had a SLB and 165 (65.2%) did not. Baseline characteristics were generally similar between SLB subgroups; however, patients who had a SLB were slightly younger and had a higher 6-min walk distance than those without a SLB. Mean FVC change over 24 weeks for pirfenidone vs. placebo was -90.9 vs. -146.3 mL, respectively, in patients who had a SLB, and 8.2 vs. -85.3 mL, respectively, in patients without a SLB. Overall, the results from the post-hoc analysis identified that pirfenidone may be an effective treatment in progressive fibrosing uILD over 24 weeks, irrespective of SLB status; however, caution should be taken when interpreting these data due to several limitations. There are differences in the treatment effect of pirfenidone between the subgroups that require further pathological and radiological investigation. In this manuscript, we also descriptively compared baseline characteristics from the overall pirfenidone in uILD study population with other uILD populations reported in the literature, with the aim of understanding if there are any similarities or differences within these cohorts. Most baseline characteristics for patients in the pirfenidone in uILD study were within the ranges reported in the literature; however, ranges were wide, highlighting the heterogeneity of uILD populations. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT03099187.
Date Issued
2022-06-17
Date Acceptance
2022-05-16
Citation
Frontiers in Medicine, 2022, 9
ISSN
2296-858X
Publisher
Frontiers Media
Journal / Book Title
Frontiers in Medicine
Volume
9
Copyright Statement
© 2022 Molina-Molina, Kreuter, Cottin, Corte, Gilberg, Kirchgaessler, Axmann and Maher. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Sponsor
National Institute for Health Research
British Lung Foundation
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35783648
Grant Number
CS-2013-13-017
C17-3
Subjects
lung function
pirfenidone
post-hoc analysis
surgical lung biopsy
unclassifiable interstitial lung disease
Publication Status
Published
Coverage Spatial
Switzerland
Article Number
ARTN 897102