Pirfenidone: an anti-fibrotic therapy for progressive kidney disease.
BACKGROUND
Many chronic diseases of various etiologies lead to fibrosis and organ dysfunction. Despite many advances in medicine in recent years, options to slow the progression of fibrotic diseases have remained limited. The recent availability of pirfenidone, an antifibrotic and anti-inflammatory investigational agent, thus offers a new hope for treating progressive fibrotic diseases.


METHODS
This review provides concise review of the available data regarding the mechanism and pharmacokinetics of pirfenidone and preclinical and clinical data regarding efficacy and safety in fibrotic diseases of the kidney. It also reviews results of clinical trials involving pirfenidone in other fibrotic diseases.


RESULTS
The review will provide in-depth review of pirfenidone with a renal focus.


CONCLUSIONS
Because many of the available clinical trials have been small and/or uncontrolled, conclusive evidence regarding efficacy and safety of pirfenidone is lacking, particularly in patients with renal or hepatic dysfunction. Larger studies are needed to better understand long-term efficacy and safety of this medication in various patient populations.
Cho
Monique E
ME
National Institutes of Health, Kidney Disease Branch, 10/CRC 5-5750, 9000 Rockville Pike, Bethesda, MD 20892-1268, USA. moniquec@intra.niddk.nih.gov
Kopp
Jeffrey B
JB
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002908:Chronic Disease / Q000188:drug therapy; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D018450:Disease Progression; D004341:Drug Evaluation; D005355:Fibrosis / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000188:drug therapy*; D011728:Pyridones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011728:Pyridones; C093844:pirfenidone