title: Composite Physiologic Index, Percent Forced Vital Capacity and Percent Diffusing Capacity for Carbon Monoxide Could Be Predictors of Pirfenidone Tolerability in Patients with Idiopathic Pulmonary Fibrosis.
abstract: OBJECTIVE
  The goals of this study were to assess the efficacy and tolerability of pirfenidone in patients with idiopathic pulmonary fibrosis (IPF) and to identify predictors of tolerability to pirfenidone.
  
  
  METHODS
  We conducted a retrospective observational study. When the patient showed deterioration in the percent forced vital capacity (%FVC) or experienced acute exacerbations or severe adverse events, treatment of the patient with pirfenidone was discontinued. We classified the patients who did not display progression following six months of pirfenidone treatment as the tolerant group and the patients who did display progression as the intolerant group. We retrospectively analyzed differences between the two groups in terms of baseline characteristics. The efficacy of pirfenidone was evaluated by the changes in vital capacity (VC) and %FVC before and after the start of treatment in the tolerant group. Patients A total of 20 patients who had been diagnosed with IPF were treated with pirfenidone.
  
  
  RESULTS
  In the tolerant group, the baseline %FVC (p=0.01) and the percentage diffusing capacity of the lungs for carbon monoxide (DLCO, p=0.02) were significantly higher, and the baseline composite physiologic index (CPI) was significantly lower (p=0.009) than in the intolerant group. In the tolerant group, pirfenidone significantly reduced the decline in VC and %FVC of the patients after treatment. In the intolerant group, five patients discontinued pirfenidone treatment because of anorexia.
  
  
  CONCLUSIONS
  We found that pirfenidone was better tolerated in patients with milder disease symptoms, as indicated by their baseline CPI, %FVC and %DLCO, and that patients in the tolerant group could benefit from the use of pirfenidone.
authors.affiliation: Department of Respiratory Medicine, Kurashiki Central Hospital, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Konishi
authors.forename: Machiko
authors.initials: M
authors.lastname: Arita
authors.forename: Isao
authors.initials: I
authors.lastname: Ito
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Tachibana
authors.forename: Takuya
authors.initials: T
authors.lastname: Takaiwa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Naoki
authors.initials: N
authors.lastname: Watanabe
authors.forename: Kazuya
authors.initials: K
authors.lastname: Tsubouchi
authors.forename: Gen
authors.initials: G
authors.lastname: Masuda
authors.forename: Maki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Youhei
authors.initials: Y
authors.lastname: Kourogi
authors.forename: Kei
authors.initials: K
authors.lastname: Kunimasa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iwasaku
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ito
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Tokioka
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Toru
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ishida
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D015415:Biomarkers / Q000378:metabolism; D002248:Carbon Monoxide / Q000378:metabolism*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000188:drug therapy* / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011728:Pyridones / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D011728:Pyridones; D002248:Carbon Monoxide; C093844:pirfenidone