Abstract
Introduction
Pirfenidone is the first agent reported to improve progression-free survival in patients with idiopathic pulmonary fibrosis (IPF), and what are now needed are data on overall survival.
Aims
Given poor prognosis, it is difficult to assess overall survival. The investigation of impact of pirfenidone associated with prognosis other than inhibition of declines in vital capacity is required. Lung carcinoma worsens prognosis. Pirfenidone inhibits transforming growth factor-beta and epithelial mesenchymal transition, which promote tumor progression. We assessed whether pirfenidone might suppress carcinogensis.
Methods
We reviewed 384 patients with chronic interstitial pneumonia in Ibarakihigashi hospital and Nippon Medical School from January 2009 to November 2013. We compared the incidence of lung carcinoma between pirfenidone and non-pirfenidone group.
Results
Mean observation time was 27.1±24.1 mo vs. 28.4±32.9 mo. The development of lung carcinoma during follow-up of interstitial pneumonia was significantly lower in the pirfenidone group (1.8% (2/113) vs. 32.5% (88/271), p<0.001).
Conclusion
The incidence of lung carcinoma was lower in pirfenidone group.
Lung carcinoma had been reported to coexist in 7.1-27.3% in IPF.
The limitations are; 1) A retrospective study conducted at two institutions. 2) We reviewed only inpatients. Most of the patients who have lung carcinoma coexisting with IPF are hospitalized and administered chemotherapy in our institutions, so the incidence of lung carcinoma might be higher.
Since the mortality from lung carcinoma is high, the prevention is important to improve prognosis of IPF. Effect of pirfenidone on lung carcinoma is the next challenging focus.
- © 2014 ERS