| Autor: |
Vicky Moore, Sherwood Burge, Geraldine Burge, Emma Briggs, Katie Neighbour, Baljit Ahitan, Gareth Walters, Helen Alldrick |
| Rok vydání: |
2017 |
| Předmět: |
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| Zdroj: |
Nurses. |
| Popis: |
Introduction: Pirfenidone and nintedanib are the first licensed drugs for IPF. Both reduce the rate of disease progression but have significant intolerability issues limiting long-term use. This study aims to identify areas where changes in practice might improve outcomes. Methods: We compared baseline characteristics of disease severity with the median time on drug, the reasons for stopping and the proportion stopping treatment within the first 4 weeks. Results: Data was available for 146/153 patients started on pirfenidone and 56/57 on nintedanib. The mean time on drug was 274 and 165 days respectively which compares favourably with international data. Photosensitivity for pirfenidone and diarrhoea for nintedanib were uncommon reasons for stopping treatment, which was more often related to upper GI intolerance and disease progression. 39 patients stopped treatment within the first 4 weeks; they could not be separated in terms of baseline characteristics including age, BMI, FVC % predicted and composite physiology index (CPI) from those continuing treatment. Shared care was associated with early discontinuation (38% vs. 20% p=0.01). Patients with shared care had more severe disease as assessed by the CPI (57.8 vs 48.8 p Conclusion: Patients stopping antifibrotic treatment early cannot be identified from baseline data but can be reduced by intensive nursing support. Prescribing centre based ILD-CNS’s should be responsible for early treatment tolerability and aim to telephone patients prescribed antifibrotic treatments weekly until established on treatment, which should be started as early as possible. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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