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CT analysis of the effect of pirfenidone in patients with idiopathic pulmonary fibrosis.

AbstractPURPOSE:
Pirfenidone is a new, anti-fibrotic drug used for the treatment of idiopathic pulmonary fibrosis (IPF). The aim of this study was to evaluate the utility of computed tomography (CT) in the imaging assessment of the response to pirfenidone therapy.
MATERIALS AND METHODS:
Subjects were 78 patients with IPF who underwent CT on two occasions with one-year interval (38 consecutive patients treated with pirfenidone and 40 age-matched control). Changes in the fibrous lesion on sequential CTs were assessed as visual score by two radiologists. We measured the volume and change per year of fibrous pattern (F-pattern) quantitatively using a computer-aided system on sequential CTs.
RESULTS:
The baseline vital capacity (%pred VC) was 74.0 ± 14.0% in the pirfenidone group and 74.6 ± 16.6% in controls (p=NS). Deterioration of respiratory status was defined as 10% or greater decline in %pred VC value after 12-month treatment. A significantly larger proportion of pirfenidone-treated patients showed stable respiratory status (21 of 38, 65.6%) than the control (15 of 40, 37.5%). The change in fibrous lesion was significantly smaller in the pirfenidone group than the control in both of visual score (p=0.006) and computer analysis (p<0.001). The decline in VC correlated significantly with the increase in fibrotic lesion (p<0.001).
CONCLUSION:
CT can be used to assess pirfenidone-induced slowing of progression of pulmonary fibrosis.
AuthorsTae Iwasawa, Takashi Ogura, Fumikazu Sakai, Tetsu Kanauchi, Takanobu Komagata, Tomohisa Baba, Toshiyuki Gotoh, Satoshi Morita, Takuya Yazawa, Tomio Inoue
JournalEuropean journal of radiology (Eur J Radiol) Vol. 83 Issue 1 Pg. 32-8 (Jan 2014) ISSN: 1872-7727 [Electronic] Ireland
PMID22465123 (Publication Type: Controlled Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Pyridones
  • pirfenidone
Topics
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis (diagnostic imaging, drug therapy)
  • Lung (diagnostic imaging, drug effects)
  • Male
  • Pyridones (therapeutic use)
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed (methods)
  • Treatment Outcome

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