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Antifibrotic treatment in patients with idiopathic pulmonary fibrosis: Our experience in 41 cases
1Departments of Pulmonary Medicine, University of Health Sciences Ankara Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
2Department of Pulmonary Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
Eurasian Journal of Pulmonology 2020; 22(3): 158-162 DOI: 10.4103/ejop.ejop_102_19
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Abstract

INTRODUCTION: It has been shown that antifibrotic agents (pirfenidone and nintedanib), used in the treatment of idiopathic pulmonary fibrosis (IPF) in recent years, decelerate the worsening of pulmonary function tests and the progression of the disease and also reduce the frequency of acute exacerbations and hospitalizations. In this study, we aimed to evaluate the results of antifibrotic treatment that we have been using since 2013 in our clinic.
MATERIALS AND METHODS: Forty-one patients diagnosed as IPF between August 1, 2013, and February 1, 2019, in the eighth clinic of our hospital were included in this study. The information of the patients was obtained from the patient files. Data were analyzed by descriptive statistical methods, Kolmogorov–Smirnov test, and Wilcoxon test.
RESULTS: Thirty-eight patients were male and three patients were female. The mean age was 65.6 ± 7.0 years. The diagnosis of 34 patients was made clinically and radiologically, and 7 patients were diagnosed pathologically. The longest usage time of antifibrotic drugs was 5.5 years in 2 patients, and the minimum usage time was 6 months in 2 patients. Thirty-four patients were using pirfenidone and seven patients were using nintedanib according to the data of their last visit. There was no significant difference between the baseline 6-min walk test results and the 6th-month, 1st-year, 2nd-year, 3rd-year, and 4th-year results. A significant decrease was determined in diffusing capacity of the lungs for carbon monoxide (DLCO) test results of the 6th month and 1st year compared to baseline (baseline: 63%, 6th month: 57%, and 1st year: 43%) (P < 0.05). There was no significant difference in DLCO test results of the 2nd, 3rd, and 4th year compared to baseline (P > 0.05). A significant decrease was determined in forced vital capacity (FVC) results of the 2nd year compared to baseline (68% and 59%, respectively) (P < 0.05). There was no significant difference in the FVC results of the 6th month, 1st year, 3rd year, and 4th year compared to baseline (P > 0.05).
CONCLUSION: Similar to the literature, we have experienced that antifibrotic drugs decelerate the progression of the disease, reduce the risk of developing exacerbations, and are more tolerable in terms of side effect profile compared to the previous treatments.