Results of this real-world study were presented in a poster titled “Pirfenidone Use in a Swedish Cohort of Patients With Pulmonary Fibrosis” during the European Respiratory Society (ERS) International Congress 2018, held in Paris, France, Sept. 15-19.
Esbriet, marketed by Genentech, has been available in Europe for the treatment of idiopathic pulmonary fibrosis (IPF) since its approval in 2011. (It also is approved for IPF in the U.S. and Asia.) The medication has been effective in reducing disease progression rates compare to placebo in several clinical trials. It is currently recommended by IPF international guidelines for the treatment of the majority of patients with the disease.
The team of researchers at Karolinska Institutet explored the real-wold treatment patterns with Esbriet in PF patients in Sweden. They reviewed the clinical records of 17,247 PF patients in the Swedish National Patient Register from 2001 to 2015.
More detailed information collected from electronic medical records obtained from primary care and four respiratory clinics in Stockholm and Uppsala was used to identify patients with IPF. A total of 291 patients with a diagnosis of IPF were included in the analysis.
Results showed that since 2011 Esbriet was prescribed at least once as a treatment for 3% of PF patients, and 26.7% of IPF patients. In the majority of cases, the treatment was prescribed more than one year after diagnosis.
The data revealed that Esbriet use was lower than expected in the Swedish PF population, compared to data from a prior study that indicated an antifibrotic prescription rate of 69.4% from 2014 to 2016. This suggests that use of this therapy “was low during the early years of its introduction” in the market, the researchers wrote.
Long-term follow-up data revealed that patients with PF continued the treatment for 297 days (median), and only 41.8% of patients persisted for at least one year. In the IPF group, median persistence was 212 days, and 29.8% of patients continued the treatment for at least one year. Still, median adherence to Esbriet was 100% during treatment duration.
Although the adherence was very good, a large proportion of patients were found to discontinue the treatment within the first six months. The researchers believed this probably is due to common adverse side effects related to the treatment that are likely to occur during this time period.
Overall, the team suggested that “the lack of persistence with pirfenidone underscores the importance of supporting and guiding patients to persist with their medications to ensure maximal benefit of treatment.”
The researchers also emphasized that the delayed prescription of Esbriet potentially may lead to “missed opportunities for patients to receive an effective treatment at an early stage of their disease.”