Pirfenidone superior to nintedanib for preventing acute exacerbation of IPF

Pirfenidone appears to confer greater reduction in the risk of acute exacerbation among patients with idiopathic pulmonary fibrosis (IPF) as compared with nintedanib, as shown in a study.

Researchers evaluated the effect of the two antifibrotic agents by comparing the frequency of acute exacerbation episodes among 199 patients with IPF. Aside from exacerbation episodes, baseline characteristics and outcomes after exacerbation onset were also analysed.

During the observation period, the cumulative incidence rates of acute exacerbation of IPF were 9.3 percent at year 1, 22.1 percent at year 2, and 25.0 percent at year 3. These numbers appeared to be lower among pirfenidone vs nintedanib users.

The respective cumulative incidence rates in the pirfenidone vs the nintedanib group were 5.1 percent vs 18.6 percent at year 1, 20.4 percent vs 25.2 percent at year 2, and 22.6 percent vs 29.6 percent at year 3. Log rank test confirmed the superiority of pirfenidone in terms of reducing the risk of acute exacerbation of IPF (p=0.035).

However, outcomes did not differ in the two treatment groups. The 3-month survival rate following the onset of acute exacerbation of IPF was 61.1 percent with pirfenidone and 61.5 percent with nintedanib.

Acute exacerbation of IPF can be fatal and occurs during the clinical course of the disease, the researchers noted. The findings suggest that pirfenidone may better protect IPF patients against this event.