February 17, 2020 at 1:31 pm #23026
My mother in India was prescribed Pirfenex 200 mg (the Indian version of Pirfenidone) for the following lungs scan report. She is 80 years old and not in great health, and could not stand it after 3 doses in 24 hours, and stopped it. My question is: is Pirfenidone applicable to her situation, and if applicable, what are other bearable / milder alternatives? Doctor is suggesting ILD (Interstitial Lung Disease). Any thoughts / advices welcome.
—-below is report—–
LUNGS: Both lung fields are well expanded and hyperinflated. Intra pulmonary bronchi and vessels are splayed, show thinning with peripheral pruning of emphysematous change. Mild centriaciner emphysema both upper lobes. Mild honeycombing with increased reticulation seen in subpleural location mainly both lower lobe basal segment more in right side. Patchy areas of ground glass haziness of alveolar exudate of pneumonitis seen in anterior segment of right upper lobe subpleural location, lateral segment of right middle lobe and in both lower lobe subpleural location. No SOL or bronchiectasis is seen.
PLEURA: No evidence of pleural effusion, thickening or calcification is seen.
HRCT Scan of thorax reveal:
Cardiomegaly, Hyperinflated emphysematous both lung fields, Non specific patchy pneumonitis also seen in both lungs. Tractional bronchiectasis also seen. Diffuse area of ground glass opacity/reticulation seen in bilateral lower lobes & mildly in anterior segments of bilateral upper lobes & right middle lobe. Rest of the lung parenchyma shows normal bronchiovascular distribution and parenchymal attenuation.
February 18, 2020 at 6:41 pm #23049Charlene MarshallKeymaster
Thanks for writing and sharing with us a bit of your Mom’s experience. Though so sorry you both are having to deal with this cruel disease as a patient and caregiver duo. The side effects of both anti-fibrotic medications can be very difficult to manage, lots of GI-related issues unfortunately. Did her doctor agree to lowering her dose? I know many patients who reduce their dose from 150mg to 100 and tolerate it much better, but it likely needs to be decided that after 3 doses. Pirfenidone (Esbriet) sounds like the medical your Mother was on, and the only other antifibrotic drug used in IPF management is OFEV. Unfortunately it is not a lot milder, still many GI-side effects but I’ve tolerated it quite well and I know others have as well. That said, I’ve never been on Esbriet so I can’t compare.
You should speak with her doctor about the unpleasant side effects though, they should be able to prescribe something to help with that or consider alternatives (ie. reducing the dose) so her quality of life isn’t as compromised. Does this help?
February 19, 2020 at 1:11 am #23061
Thanks Charlene. A different doctor changed the med to omnacortil, a steroid. I think she will take that, hopefully has not too much side effects. – amit.
February 19, 2020 at 1:16 am #23062
She also has Rheumatoid arthritis, and I read this steroid works on that too.
February 19, 2020 at 11:21 am #23070Charlene MarshallKeymaster
Thanks so much for circling back and letting us know how your Mom is doing. I hope this steroid is more tolerable for her, I’ll keep my fingers crossed her side effects are lessened. Let us know how she’s doing. Thanks for writing.
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