Besides its other benefits, Esbriet (pirfenidone) prevents respiratory-related hospitalizations in patients with idiopathic pulmonary fibrosis (IPF), according to a study examining data from more than 1,200 patients.
Findings also showed that hospitalized patients who took Esbriet were less likely to die after one year. This effect decreased over time, though researchers still consider preventing hospital admissions in the first place an important goal of IPF treatment.
The study, “Pirfenidone reduces respiratory-related hospitalizations in idiopathic pulmonary fibrosis” — a collaboration between Genentech (which funded the research) and the University of California, San Francisco — appeared in the American Journal of Respiratory and Critical Care Medicine.
IPF patients who must be hospitalized have higher rates of death and additional illness. Studies show hospitalizations affect how patients feel and function. In addition, hospitalizations related to respiratory causes are also easier to identify than acute IPF exacerbations, making measurements more reliable.
The research team gathered data from the two Phase 3 clinical trials CAPACITY (NCT00287729, NCT00287716) and the Phase 3 ASCEND trial (NCT01366209) — all examining Esbriet in IPF patients. About half of the 1,247 patients involved were treated with Esbriet. Total hospitalization rates were similar in the placebo (18 percent) and Esbriet-treated groups (17 percent).
But when looking only at respiratory-related hospitalizations, only 7 percent of those on Esbriet had to be admitted to a hospital, compared to 12 percent on placebo, translating to a nearly halved risk of hospitalization for those in the Esbriet group. Moreover, only 17 percent of those on Esbriet died after hospital stays for any reason, compared to 32 percent on placebo.
The difference, researchers noted, seemed to be driven by lower death rates after respiratory-related hospitalizations. Looking at data from patients followed up to 52 weeks showed a lower risk of death with Esbriet. But when the team looked at patients followed for 72 weeks, the lower risk of death was no longer obvious.
Despite the lack of clarity in how Esbriet affects mortality after hospitalization in the longer term, the team stressed that lowering hospitalization rates is valuable in itself. “We believe reducing the risk of respiratory hospitalization is an important goal of therapy,” they wrote, suggesting that the measure should also be included in future IPF clinical trials.
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