Is pirfenidone effective for idiopathic pulmonary fibrosis?

Medwave. 2017 Jan 17;17(Suppl1):e6843. doi: 10.5867/medwave.2017.6844.
[Article in Spanish, English]

Abstract

Idiopathic pulmonary fibrosis has an ominous prognosis and there are virtually no effective therapies. It has been suggested that pirfenidone, an antifibrotic agent, could change its course. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified 13 systematic reviews comprising nine trials addressing the question of this article, seven of which are randomized and whose results were analyzed in this summary. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded pirfenidone decreases disease progression and mortality in idiopathic pulmonary fibrosis. Although it is associated with frequent gastrointestinal and cutaneous adverse effects, these are generally not severe.

Se ha planteado que la pirfenidona, un agente antifibrótico, podría cambiar el curso de la fibrosis pulmonar idiopática, una enfermedad de pronóstico ominoso y para la cual prácticamente no existen terapias efectivas. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples bases de datos, identificamos trece revisiones sistemáticas que en conjunto incluyen nueve estudios primarios, siete de los cuales son aleatorizados y cuyos resultados se analizaron en este resumen. Extrajimos los datos, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la pirfenidona disminuye la progresión de la enfermedad y la mortalidad en la fibrosis pulmonar idiopática. Si bien se asocia a efectos adversos gastrointestinales y cutáneos frecuentes, estos en general no son severos.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Disease Progression
  • Humans
  • Idiopathic Pulmonary Fibrosis / drug therapy*
  • Idiopathic Pulmonary Fibrosis / mortality
  • Idiopathic Pulmonary Fibrosis / physiopathology
  • Pyridones / adverse effects
  • Pyridones / pharmacology
  • Pyridones / therapeutic use*
  • Randomized Controlled Trials as Topic

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Pyridones
  • pirfenidone