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Nintedanib and pirfenidone for idiopathic pulmonary fibrosis in King Abdulaziz Medical City, Riyadh: Real-life data
Mohammed Ayaz Khan1, Nahed Sherbini2, Sami Alyami1, Abdullah Al-Harbi1, Majed Al-Ghamdi1, Suliman Alrajhi3, Rajkumar Rajendram4, Hamdan Al-Jahdali1
1 Department of Medicine, College of Medicine, King Saud University for Health Sciences; King Abdullah International Medical Research Centre; Department of Medicine, Division of Pulmonary, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
2 Department of Medicine, College of Medicine, King Saud University for Health Sciences; King Abdullah International Medical Research Centre; Division of Pulmonology, Prince Mohammed bin Abdulaziz Hospital, National Guard Health Affairs, Madina, Saudi Arabia
3 Department of Medicine, College of Medicine, King Saud University for Health Sciences; King Abdullah International Medical Research Centre; Department of Radiology, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
4 Department of Medicine, College of Medicine, King Saud University for Health Sciences; King Abdullah International Medical Research Centre; Department of Medicine, Division of Internal Medicine, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
Correspondence Address:
Dr. Hamdan Al-Jahdali
McGill University, Montreal, Canada, Division of Pulmonary, King Saud University for Health Sciences, Riyadh; Sleep Disorders Center, King Abdulaziz Medical City, Riyadh
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/atm.atm_206_22
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BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic progressive age-related lung disease causing relentless fibrosis of the lung parenchyma. Currently, pirfenidone and nintedanib are the two antifibrotic drugs, approved for the treatment of IPF. Both are shown to slow progression by preserving lung functions from rapid decline compared to a placebo. We are reporting a real-life patient experience using these two antifibrotic medications (AFMs) in our tertiary care hospital.
METHODS: A retrospective cohort study was conducted for all IPF cases diagnosed in multidisciplinary meetings between 2015 and 2020 at KAMC, Riyadh (Saudi Arabia). We are reporting patients' demographics, lung function, survival, tolerance, side effects, or death in patients taking AFMs.
RESULTS: A total of 81 cases were identified. The majority of patients aged 67 years (68%) were men with a median age of 68 years. Late presentation, severe disease, and definite usual interstitial pneumonia patterns were reported in 60% of our patients. The average number of hospital admissions before starting treatment was 1 (range: 0–3) in the nintedanib group and 1.4 (range: 1.2–5) in the pirfenidone group. There was an increase in the number of hospital admissions in the group started on pirfenidone 1.7 (range: 1.9–8) compared to nintedanib 0.5 (range: 0–3), P = 0.001. The observed mortality outcome in this cohort was 4 (11%) and 12 (27%) for nintedanib and pirfenidone, respectively. The predominant side effects were gastrointestinal symptoms for both the groups 18 (22%).
CONCLUSIONS: Pirfenidone and nintedanib are the available approved antifibrotic agents used for many years to treat IPF patients. Real-life data showed better tolerability than reported in the West, good compliance, and a manageable side effect profile in this group of elderly and severe IPF patients.
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