From the Guidelines
Esbriet (Pirfenidone) should be used to treat idiopathic pulmonary fibrosis (IPF) in patients with mild-to-moderate disease, as it has been shown to slow the decline in lung function and may improve survival outcomes. The medication works by reducing fibroblast proliferation and the production of fibrosis-associated proteins and cytokines, thereby slowing the progression of lung scarring 1.
Key Points to Consider
- The standard dosing regimen begins with 267 mg three times daily for one week, increases to 534 mg three times daily for the second week, and then reaches the maintenance dose of 801 mg three times daily thereafter.
- Common side effects include nausea, rash, fatigue, stomach upset, and photosensitivity, so patients should use sunscreen and protective clothing when outdoors.
- Liver function tests should be monitored regularly during treatment, and patients should avoid grapefruit juice which can interact with the medication.
- Smoking can reduce the effectiveness of Esbriet, so smoking cessation is strongly recommended for patients on this therapy 1.
Patient Selection and Monitoring
- Treatment should be initiated and supervised by a physician experienced in the diagnosis and management of IPF.
- Patients must not smoke during pirfenidone treatment and should be warned against UV exposure.
- Regular monitoring of clinical tolerance and liver enzymes is required. The use of Esbriet (Pirfenidone) in IPF patients is supported by a conditional recommendation with moderate confidence in estimates of effect, as stated in the 2015 clinical practice guideline by the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Association 1.
From the FDA Drug Label
1 INDICATIONS AND USAGE Pirfenidone is indicated for the treatment of idiopathic pulmonary fibrosis (IPF).
INDICATIONS AND USAGE Pirfenidone is a pyridone indicated for the treatment of idiopathic pulmonary fibrosis (IPF). What is pirfenidone Pirfenidone is a prescription medicine used to treat people with a lung disease called idiopathic pulmonary fibrosis (IPF).
The use of Esbriet (Pirfenidone) is for the treatment of idiopathic pulmonary fibrosis (IPF).
- Key indication: Idiopathic pulmonary fibrosis (IPF)
- Prescription use: Pirfenidone is a prescription medicine used to treat IPF 2, 2, 2
From the Research
Use of Esbriet (Pirfenidone)
- Esbriet (Pirfenidone) is an orally administered, synthetic, pyridone compound approved for the treatment of adults with mild to moderate idiopathic pulmonary fibrosis (IPF) in the EU and for the treatment of IPF in the USA 3.
- The primary use of Pirfenidone is to slow down the progression of IPF, a devastating interstitial lung disease, by reducing the rate of decline in forced vital capacity (FVC) and prolonging progression-free survival 4, 5.
- Pirfenidone has been shown to have a significant treatment effect on the 6-min walking test distance and progression-free survival in patients with IPF 3, 6.
- The medication is generally well-tolerated, with the most common side effects being gastrointestinal and skin-related events, such as nausea, rash, and photosensitivity reaction, which are usually mild to moderate in severity 3, 6, 7.
Benefits of Pirfenidone
- Reduces the rate of decline in forced vital capacity (FVC) in patients with mild to moderate IPF 3, 4, 6.
- Prolongs progression-free survival in IPF patients with mild-to-moderate disease 3, 6.
- Improves the 6-min walking test distance in patients with IPF 3, 6.
- Reduces IPF-related and all-cause mortality in patients with IPF 3.
Safety and Adverse Event Management
- Pirfenidone has a manageable tolerability profile, with the most common adverse events being gastrointestinal and skin-related events 3, 6, 7.
- Key strategies for preventing and managing pirfenidone-related adverse events include monitoring for gastrointestinal and skin-related events, and adjusting the dose or discontinuing treatment if necessary 7.