Impact of novel antifibrotic therapy on patient outcomes in idiopathic pulmonary fibrosis: patient selection and perspectives

Figures & data

Figure 1 Positive and negative influences on HRQL in IPF.

Notes: Symptoms, and dyspnea in particular, are the most influential drivers of impaired HRQL in IPF. Other drivers of impaired HRQL include the resultant physical functional limitations due to deconditioning, mood disorders and comorbidities, and the constraints of supplemental oxygen. Pulmonary rehabilitation is associated with improved HRQL in IPF. Pharmacologic therapies, management of comorbid conditions, and a multidisciplinary approach to diagnosis and management may also improve HRQL for some patients.
Abbreviations: HRQL, health-related quality of life; IPF, idiopathic pulmonary fibrosis.

Table 1 Comparison of antifibrotic agents approved for the treatment of IPF

	Nintedanib	Pirfenidone
Efficacy	• Slower rate of decline in forced vital capacity over 1 year when compared with placebo • Reduction in acute exacerbations • Lower all-cause mortality at 1 year	• Slower rate of decline in forced vital capacity over 1 year when compared with placebo • Improved progression-free survival • Reduction in respiratory-related hospitalizations • Lower all-cause mortality at 1 year
Potential side effects	• Diarrhea • Weight loss • Elevated liver enzymes	• Nausea • Photosensitivity • Elevated liver enzymes
Dosing	• One capsule taken twice per day	• Three capsules taken three times per day
Contraindications	• No absolute contraindications • Not recommended in Child Pugh Class B or C hepatic impairment • Caution in patients with high cardiovascular risk or high risk for bleeding	• No absolute contraindications
Impact on quality of life	• Slower rate of decline in respiratory-specific quality of life as measured by St. George’s Respiratory Questionnaire	• May slow the progression of worsening dyspnea

Abbreviation: IPF, idiopathic pulmonary fibrosis.