David Bennett1, Rosa Metella Refini2, Maria Lucia Valentini2, Annalisa Fui2, Antonella Fossi2, Maria Pieroni2, Maria Antonietta Mazzei3, Paola Rottoli2. 1. Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) - Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Viale Bracci, 16, 53100, Siena, Italy. david.btt@gmail.com. 2. Respiratory Diseases and Lung Transplantation Unit, Azienda Ospedaliera Universitaria Senese (AOUS) - Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Viale Bracci, 16, 53100, Siena, Italy. 3. Diagnostic Imaging Unit, Azienda Ospedaliera Universitaria Senese (AOUS) - Department of Medical and Surgical Sciences & Neurosciences, University of Siena, Siena, Italy.
Abstract
INTRODUCTION: Familial pulmonary fibrosis (FPF) is defined as an idiopathic diffuse parenchymal lung disease affecting two or more members of the same primary biological family. The aim of this study was to compare disease progression and tolerance to pirfenidone in a population of FPF patients who presented with radiological and/or histological evidence of UIP, and a group of idiopathic pulmonary fibrosis (IPF) patients. METHODS: Seventy-three patients (19 with FPF and 54 with IPF) were enrolled and data were collected retrospectively at 6, 12 and 24 months follow-up. RESULTS: FPF patients were statistically younger and more frequently females. A significantly greater decline in FVC and DLCO was recorded in FPF than in IPF patients at 24 months follow-up. At the 6-min walking test, walked distance declined significantly in FPF patients than IPF at 24 months. No statistically significant differences in drug tolerance or side effects were recorded between groups. CONCLUSION: Different rate of progression was observed in patients with IPF and FPF on therapy with pirfenidone; our findings may not be due to lack of effectiveness of therapy, but to the different natural history and evolution of these two conditions. Pirfenidone was well tolerated by FPF and IPF patients. Specific unbiased randomized clinical trials on larger populations to validate our preliminary exploratory results are needed.
INTRODUCTION:Familial pulmonary fibrosis (FPF) is defined as an idiopathic diffuse parenchymal lung disease affecting two or more members of the same primary biological family. The aim of this study was to compare disease progression and tolerance to pirfenidone in a population of FPFpatients who presented with radiological and/or histological evidence of UIP, and a group of idiopathic pulmonary fibrosis (IPF) patients. METHODS: Seventy-three patients (19 with FPF and 54 with IPF) were enrolled and data were collected retrospectively at 6, 12 and 24 months follow-up. RESULTS:FPFpatients were statistically younger and more frequently females. A significantly greater decline in FVC and DLCO was recorded in FPF than in IPFpatients at 24 months follow-up. At the 6-min walking test, walked distance declined significantly in FPFpatients than IPF at 24 months. No statistically significant differences in drug tolerance or side effects were recorded between groups. CONCLUSION: Different rate of progression was observed in patients with IPF and FPF on therapy with pirfenidone; our findings may not be due to lack of effectiveness of therapy, but to the different natural history and evolution of these two conditions. Pirfenidone was well tolerated by FPF and IPFpatients. Specific unbiased randomized clinical trials on larger populations to validate our preliminary exploratory results are needed.
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