BackgroundPatients with severe COVID-19 may develop lung fibrosis. Pirfenidone is an anti-fibrotic drug approved for idiopathic pulmonary fibrosis. The efficacy and safety of pirfenidone in patients with fibrotic interstitial lung changes after recovery from severe COVID-19 pneumonia was evaluated.MethodsPhase 2, double-blind, placebo-controlled, Spanish multicenter clinical trial randomized to receive pirfenidone or placebo (2:1) for 24-weeks. The primary endpoint was the proportion of patients that improved, considered when percent change in forced vital capacity (FVC) was ≥10% and/or any reduction in the fibrotic score chest high-resolution computed tomography (HRCT). Secondary endpoints included health-related quality of life (HRQoL), exercise capacity, and drug safety profile.ResultsFrom 119 eligible patients, 113 were randomized and 103 were analyzed (pirfenidone n=69, placebo n=34). Most patients were male (73.5%) and were receiving low-dose prednisone; mean age was 63.7 years and body-mass index was 29 kg·m−2. The percentage of patients that improved was similar in the pirfenidone and placebo groups (79.7% versus 82.3%, respectively). The mean predicted FVC (%) increased 12.74 (20.6) with pirfenidone and 4.35 (22.3) with placebo (p=0.071), and the HRCT (%) fibrotic score reduced 5.44 (3.69) with pirfenidone and 2.57 (2.59) with placebo (p=0.52). Clinically meaningful improvement in HRQoL was not statistically different (55.2% in pirfenidone and 39.4% in placebo group, respectively). Exercise capacity, adverse events and hospitalizations were similar between groups. No deaths were reported.ConclusionsThe overall improvement in lung function and the HRCT fibrotic score after 6 months with pirfenidone was not significantly different than placebo.

More than 300 patients are at the centre of a Western long COVID study, which hopes to find an effective treatment for those who struggle with long COVID.

Dr. Niyati A. Borkar speaks with Dr. Yaping Tu and Dr. Thomas B. Casale about their article, "Pirfenidone and its Derivative: Novel Bronchodilators and Leukocyte Airway Inflammation Inhibitors."

Western and Schmidt Initiative for Long Covid will test two existing drugs as treatments for long COVID in a clinical trial with patients worldwide.

Spanning four continents and enrolling hundreds of people, a new clinical trial will test the effectiveness of two anti-inflammatory medicines as potential treatments for long COVID, scientists from W...

Researchers at Schulich Medicine & Dentistry and Schmidt Initiative for Long Covid will enroll more than 300 patients across four continents.

BackgroundIdiopathic pulmonary fibrosis (IPF) carries a high risk of lung cancer, but the effect of pirfenidone on lung cancer development remains uncertain. We investigated the association between pirfenidone use and lung cancer development in patients with IPF.MethodsWe included 10 084 patients with IPF from the national claims database. Propensity score analysis with inverse probability of treatment weighting (IPTW) and landmark analyses were employed to evaluate lung cancer occurrence according to pirfenidone use. The association was evaluated using Cox regression models adjusted for clinical and socioeconomic variables. A single-center IPF clinical cohort (n=941) was used for validating the findings.ResultsThe mean patient age was 69.4 years, 73.8% were men, and 31.6% received pirfenidone. Lung cancer developed in 766 patients with IPF (7.6%; 21.9 cases per 1000 person-years) during a median follow-up of 3.0 years. After IPTW, the pirfenidone group showed lower incidence (10.4 versus 27.9 cases per 1000 person-years) than the no-pirfenidone group. Landmark analysis at 6 months after IPF diagnosis also showed lower incidence of lung cancer in the pirfenidone group than in the no-pirfenidone group. Pirfenidone use was independently associated with a reduced lung cancer risk (weighted adjusted hazard ratio [HR]: 0.347; 95% confidence interval [CI]: 0.258–0.466). A clinical cohort showed similar association (weighted adjusted HR: 0.716; 95% CI: 0.517–0.991). The association persisted across subgroups defined by age or sex.ConclusionPirfenidone use may be associated with a reduced lung cancer risk in patients with IPF.

In this modelling study, Qiu-Yi Pan and colleagues provide a cost-effectiveness analysis of pirfenidone plus glucocorticoids versus glucocorticoids alone for the treatment of Grade 2 and Grade 3 Radia...

Deupirfenidone, a deuterated form of pirfenidone, may offer better efficacy and tolerability than its predecessor

Background Although post-COVID-19 interstitial lung abnormalities (ILAs) are common, the use of antifibrotic agents to prevent their onset and progression is controversial. We aimed to investigate t...

Pirfenidone (PFD) has been used to treat kidney fibrosis. However, the effects of PFD on obesity-related kidney injury and the underlying mechanisms a…