Real-World Study Finds High Adherence, Persistence With Pirfenidone Treatment in IPF

During the American Thoracic Society’s Annual Meeting in Dallas, Texas, taking place May 17-22, 2019, researchers will present findings from a study investigating pirfenidone (Esbriet) in the treatment of idiopathic pulmonary fibrosis (IPF) in a real-world setting.

The study sought to determine the adherence and persistence of pirfenidone and nintedanib (Ofev) in the Medicare patient population. A retrospective observational study of Medicare beneficiaries was conducted using the 100% Medicare Research Identifiable File.

Patients 67 years and older who were diagnosed with IPF from January 2010 to December 2015 on or before initiation of antifibrotic therapy between October 15, 2014, and December 31, 2015, were included within the study. The inclusion criteria identified 3546 patients within the time period who initiated treatment with antifibrotics. The cohort was then divided into 2 groups: patients taking pirfenidone (n = 2082) and patients taking nintedanib (n = 1464).

The study authors compared adherence (proportion of days covered ≥0.80) and persistence, including continuation of therapy (use without gap of ≥60 days) and discontinuation (ie, stopping or switching index therapy), between study groups.

Follow-up was conducted at 204 days and 189 days for pirfenidone and nintedanib, respectively. Researchers found that adherence and persistence rates were higher for patients receiving pirfenidone. Specifically, the study determined that discontinuation rates were 19.5% among patients taking pirfenidone compared with 26.0% for nintedanib. Additionally, during the study period, 5.1% of patients switched while receiving pirfenidone compared with 3.1% of patients switching while receiving nintedanib.

Overall, the authors concluded that persistence and adherence were both statistically significantly higher in the pirfenidone arm than the nintedanib arm, although further analysis may be required to determine if these trends continue over time.

Reference

Corral M, Reddy S, Chang E, Broder M, Gokhale S, Raimundo K. Rates of adherence and persistence of antifibrotic therapies in the US Medicare population. Presented at: American Thoracic Society 2019 Annual Meeting; May 17-22; Dallas, Texas. Abstract A4094/116.