Tae Iwasawa1, Takashi Ogura2, Fumikazu Sakai3, Tetsu Kanauchi4, Takanobu Komagata5, Tomohisa Baba2, Toshiyuki Gotoh6, Satoshi Morita7, Takuya Yazawa8, Tomio Inoue9. 1. Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. Electronic address: tae_i_md@wb3.so-net.ne.jp. 2. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. 3. Department of Diagnostic Radiology, International Medical Center of Saitama Medical University, Saitama, Japan. 4. Department of Radiology, Saitama Cardiovascular and Respiratory Center, Saitama, Japan. 5. Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. 6. Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Japan. 7. Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Japan. 8. Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan. 9. Department of Radiology Yokohama City University, School of Medicine, Yokohama, Japan.
Abstract
PURPOSE:Pirfenidone is a new, anti-fibrotic drug used for the treatment of idiopathic pulmonary fibrosis (IPF). The aim of this study was to evaluate the utility of computed tomography (CT) in the imaging assessment of the response to pirfenidone therapy. MATERIALS AND METHODS:Subjects were 78 patients with IPF who underwent CT on two occasions with one-year interval (38 consecutive patients treated withpirfenidone and 40 age-matched control). Changes in the fibrous lesion on sequential CTs were assessed as visual score by two radiologists. We measured the volume and change per year of fibrous pattern (F-pattern) quantitatively using a computer-aided system on sequential CTs. RESULTS: The baseline vital capacity (%pred VC) was 74.0 ± 14.0% in the pirfenidone group and 74.6 ± 16.6% in controls (p=NS). Deterioration of respiratory status was defined as 10% or greater decline in %pred VC value after 12-month treatment. A significantly larger proportion of pirfenidone-treated patients showed stable respiratory status (21 of 38, 65.6%) than the control (15 of 40, 37.5%). The change in fibrous lesion was significantly smaller in the pirfenidone group than the control in both of visual score (p=0.006) and computer analysis (p<0.001). The decline in VC correlated significantly with the increase in fibrotic lesion (p<0.001). CONCLUSION:CT can be used to assess pirfenidone-induced slowing of progression of pulmonary fibrosis.
RCT Entities:
PURPOSE:Pirfenidone is a new, anti-fibrotic drug used for the treatment of idiopathic pulmonary fibrosis (IPF). The aim of this study was to evaluate the utility of computed tomography (CT) in the imaging assessment of the response to pirfenidone therapy. MATERIALS AND METHODS: Subjects were 78 patients with IPF who underwent CT on two occasions with one-year interval (38 consecutive patients treated with pirfenidone and 40 age-matched control). Changes in the fibrous lesion on sequential CTs were assessed as visual score by two radiologists. We measured the volume and change per year of fibrous pattern (F-pattern) quantitatively using a computer-aided system on sequential CTs. RESULTS: The baseline vital capacity (%pred VC) was 74.0 ± 14.0% in the pirfenidone group and 74.6 ± 16.6% in controls (p=NS). Deterioration of respiratory status was defined as 10% or greater decline in %pred VC value after 12-month treatment. A significantly larger proportion of pirfenidone-treated patients showed stable respiratory status (21 of 38, 65.6%) than the control (15 of 40, 37.5%). The change in fibrous lesion was significantly smaller in the pirfenidone group than the control in both of visual score (p=0.006) and computer analysis (p<0.001). The decline in VC correlated significantly with the increase in fibrotic lesion (p<0.001). CONCLUSION: CT can be used to assess pirfenidone-induced slowing of progression of pulmonary fibrosis.
Authors: Samuel Y Ash; Rola Harmouche; Rachel K Putman; James C Ross; Alejandro A Diaz; Gary M Hunninghake; Jorge Onieva Onieva; Fernando J Martinez; Augustine M Choi; David A Lynch; Hiroto Hatabu; Ivan O Rosas; Raul San Jose Estepar; George R Washko Journal: Chest Date: 2017-05-12 Impact factor: 9.410
Authors: Matthew R Lammi; Robert P Baughman; Surinder S Birring; Anne-Marie Russell; Jay H Ryu; Marybeth Scholand; Oliver Distler; Daphne LeSage; Catherine Sarver; Katerina Antoniou; Kristin B Highland; Otylia Kowal-Bielecka; Joseph A Lasky; Athol U Wells; Lesley Ann Saketkoo Journal: Curr Respir Med Rev Date: 2015