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Pirfenidone for idiopathic pulmonary fibrosis: analysis of pooled data from three multinational phase 3 trials.

Identifieur interne : 002353 ( PubMed/Curation ); précédent : 002352; suivant : 002354

Pirfenidone for idiopathic pulmonary fibrosis: analysis of pooled data from three multinational phase 3 trials.

Auteurs : Paul W. Noble ; Carlo Albera [Italie] ; Williamson Z. Bradford [États-Unis] ; Ulrich Costabel [Allemagne] ; Roland M. Du Bois [Royaume-Uni] ; Elizabeth A. Fagan [États-Unis] ; Robert S. Fishman [États-Unis] ; Ian Glaspole [Australie] ; Marilyn K. Glassberg [États-Unis] ; Lisa Lancaster [États-Unis] ; David J. Lederer [États-Unis] ; Jonathan A. Leff [États-Unis] ; Steven D. Nathan [États-Unis] ; Carlos A. Pereira [Brésil] ; Jeffrey J. Swigris [États-Unis] ; Dominique Valeyre [France] ; Talmadge E. King [États-Unis]

Source :

RBID : pubmed:26647432

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English descriptors

Abstract

Pirfenidone is an antifibrotic agent that has been evaluated in three multinational phase 3 trials in patients with idiopathic pulmonary fibrosis (IPF). We analysed pooled data from the multinational trials to obtain the most precise estimates of the magnitude of treatment effect on measures of disease progression.All patients randomised to pirfenidone 2403 mg·day(-1) or placebo in the CAPACITY or ASCEND studies were included in the analysis. Pooled analyses of outcomes at 1 year were based on the pre-specified end-points and analytic methods described in the ASCEND study protocol.A total of 1247 patients were included in the analysis. At 1 year, pirfenidone reduced the proportion of patients with a ≥10% decline in per cent predicted forced vital capacity or death by 43.8% (95% CI 29.3-55.4%) and increased the proportion of patients with no decline by 59.3% (95% CI 29.0-96.8%). A treatment benefit was also observed for progression-free survival, 6-min walk distance and dyspnoea. Gastrointestinal and skin-related adverse events were more common in the pirfenidone group, but rarely led to discontinuation.Analysis of data from three phase 3 trials demonstrated that treatment with pirfenidone for 1 year resulted in clinically meaningful reductions in disease progression in patients with IPF.

DOI: 10.1183/13993003.00026-2015
PubMed: 26647432

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Paul W. Noble
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Le document en format XML

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<div type="abstract" xml:lang="en">Pirfenidone is an antifibrotic agent that has been evaluated in three multinational phase 3 trials in patients with idiopathic pulmonary fibrosis (IPF). We analysed pooled data from the multinational trials to obtain the most precise estimates of the magnitude of treatment effect on measures of disease progression.All patients randomised to pirfenidone 2403 mg·day(-1) or placebo in the CAPACITY or ASCEND studies were included in the analysis. Pooled analyses of outcomes at 1 year were based on the pre-specified end-points and analytic methods described in the ASCEND study protocol.A total of 1247 patients were included in the analysis. At 1 year, pirfenidone reduced the proportion of patients with a ≥10% decline in per cent predicted forced vital capacity or death by 43.8% (95% CI 29.3-55.4%) and increased the proportion of patients with no decline by 59.3% (95% CI 29.0-96.8%). A treatment benefit was also observed for progression-free survival, 6-min walk distance and dyspnoea. Gastrointestinal and skin-related adverse events were more common in the pirfenidone group, but rarely led to discontinuation.Analysis of data from three phase 3 trials demonstrated that treatment with pirfenidone for 1 year resulted in clinically meaningful reductions in disease progression in patients with IPF.</div>
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<DateCompleted>
<Year>2017</Year>
<Month>01</Month>
<Day>10</Day>
</DateCompleted>
<DateRevised>
<Year>2017</Year>
<Month>01</Month>
<Day>11</Day>
</DateRevised>
<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Electronic">1399-3003</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>47</Volume>
<Issue>1</Issue>
<PubDate>
<Year>2016</Year>
<Month>Jan</Month>
</PubDate>
</JournalIssue>
<Title>The European respiratory journal</Title>
<ISOAbbreviation>Eur. Respir. J.</ISOAbbreviation>
</Journal>
<ArticleTitle>Pirfenidone for idiopathic pulmonary fibrosis: analysis of pooled data from three multinational phase 3 trials.</ArticleTitle>
<Pagination>
<MedlinePgn>243-53</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1183/13993003.00026-2015</ELocationID>
<Abstract>
<AbstractText>Pirfenidone is an antifibrotic agent that has been evaluated in three multinational phase 3 trials in patients with idiopathic pulmonary fibrosis (IPF). We analysed pooled data from the multinational trials to obtain the most precise estimates of the magnitude of treatment effect on measures of disease progression.All patients randomised to pirfenidone 2403 mg·day(-1) or placebo in the CAPACITY or ASCEND studies were included in the analysis. Pooled analyses of outcomes at 1 year were based on the pre-specified end-points and analytic methods described in the ASCEND study protocol.A total of 1247 patients were included in the analysis. At 1 year, pirfenidone reduced the proportion of patients with a ≥10% decline in per cent predicted forced vital capacity or death by 43.8% (95% CI 29.3-55.4%) and increased the proportion of patients with no decline by 59.3% (95% CI 29.0-96.8%). A treatment benefit was also observed for progression-free survival, 6-min walk distance and dyspnoea. Gastrointestinal and skin-related adverse events were more common in the pirfenidone group, but rarely led to discontinuation.Analysis of data from three phase 3 trials demonstrated that treatment with pirfenidone for 1 year resulted in clinically meaningful reductions in disease progression in patients with IPF.</AbstractText>
<CopyrightInformation>Copyright ©ERS 2016.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Noble</LastName>
<ForeName>Paul W</ForeName>
<Initials>PW</Initials>
<AffiliationInfo>
<Affiliation>Cedars-Sinai Medical Center, Los Angeles, CA, USA Paul.Noble@cshs.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Albera</LastName>
<ForeName>Carlo</ForeName>
<Initials>C</Initials>
<AffiliationInfo>
<Affiliation>University of Turin, Turin, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Bradford</LastName>
<ForeName>Williamson Z</ForeName>
<Initials>WZ</Initials>
<AffiliationInfo>
<Affiliation>InterMune Inc., Brisbane, CA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Costabel</LastName>
<ForeName>Ulrich</ForeName>
<Initials>U</Initials>
<AffiliationInfo>
<Affiliation>Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>du Bois</LastName>
<ForeName>Roland M</ForeName>
<Initials>RM</Initials>
<AffiliationInfo>
<Affiliation>Imperial College, London, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Fagan</LastName>
<ForeName>Elizabeth A</ForeName>
<Initials>EA</Initials>
<AffiliationInfo>
<Affiliation>InterMune Inc., Brisbane, CA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Fishman</LastName>
<ForeName>Robert S</ForeName>
<Initials>RS</Initials>
<AffiliationInfo>
<Affiliation>InterMune Inc., Brisbane, CA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Glaspole</LastName>
<ForeName>Ian</ForeName>
<Initials>I</Initials>
<AffiliationInfo>
<Affiliation>Alfred Hospital and Monash University, Melbourne, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Glassberg</LastName>
<ForeName>Marilyn K</ForeName>
<Initials>MK</Initials>
<AffiliationInfo>
<Affiliation>University of Miami Miller School of Medicine, Miami, FL, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Lancaster</LastName>
<ForeName>Lisa</ForeName>
<Initials>L</Initials>
<AffiliationInfo>
<Affiliation>Vanderbilt University Medical Center, Nashville, TN, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Lederer</LastName>
<ForeName>David J</ForeName>
<Initials>DJ</Initials>
<AffiliationInfo>
<Affiliation>Columbia University Medical Center, New York, NY, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Leff</LastName>
<ForeName>Jonathan A</ForeName>
<Initials>JA</Initials>
<AffiliationInfo>
<Affiliation>InterMune Inc., Brisbane, CA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Nathan</LastName>
<ForeName>Steven D</ForeName>
<Initials>SD</Initials>
<AffiliationInfo>
<Affiliation>Inova Fairfax Hospital, Falls Church, VA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Pereira</LastName>
<ForeName>Carlos A</ForeName>
<Initials>CA</Initials>
<AffiliationInfo>
<Affiliation>Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Swigris</LastName>
<ForeName>Jeffrey J</ForeName>
<Initials>JJ</Initials>
<AffiliationInfo>
<Affiliation>National Jewish Health, Denver, CO, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Valeyre</LastName>
<ForeName>Dominique</ForeName>
<Initials>D</Initials>
<AffiliationInfo>
<Affiliation>Assistance Publique-Hôpitaux de Paris, Avicenne University Hospital, Bobigny, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>King</LastName>
<ForeName>Talmadge E</ForeName>
<Initials>TE</Initials>
<Suffix>Jr</Suffix>
<AffiliationInfo>
<Affiliation>University of California, San Francisco, San Francisco, CA, USA.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D017418">Meta-Analysis</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2015</Year>
<Month>12</Month>
<Day>02</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>England</Country>
<MedlineTA>Eur Respir J</MedlineTA>
<NlmUniqueID>8803460</NlmUniqueID>
<ISSNLinking>0903-1936</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000894">Anti-Inflammatory Agents, Non-Steroidal</NameOfSubstance>
</Chemical>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D011728">Pyridones</NameOfSubstance>
</Chemical>
<Chemical>
<RegistryNumber>D7NLD2JX7U</RegistryNumber>
<NameOfSubstance UI="C093844">pirfenidone</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<CommentsCorrectionsList>
<CommentsCorrections RefType="Cites">
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<CommentsCorrections RefType="CommentIn">
<RefSource>Eur Respir J. 2016 Jan;47(1):27-30</RefSource>
<PMID Version="1">26721960</PMID>
</CommentsCorrections>
</CommentsCorrectionsList>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000894" MajorTopicYN="N">Anti-Inflammatory Agents, Non-Steroidal</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D017326" MajorTopicYN="N">Clinical Trials, Phase III as Topic</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D018450" MajorTopicYN="N">Disease Progression</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005080" MajorTopicYN="N">Exercise Test</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005541" MajorTopicYN="N">Forced Expiratory Volume</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D054990" MajorTopicYN="N">Idiopathic Pulmonary Fibrosis</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007391" MajorTopicYN="N">International Cooperation</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011653" MajorTopicYN="N">Pulmonary Diffusing Capacity</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011728" MajorTopicYN="N">Pyridones</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D014797" MajorTopicYN="N">Vital Capacity</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<OtherID Source="NLM">PMC4697914</OtherID>
</MedlineCitation>
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<History>
<PubMedPubDate PubStatus="received">
<Year>2015</Year>
<Month>01</Month>
<Day>08</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2015</Year>
<Month>09</Month>
<Day>01</Day>
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