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P135 Maintenance of antifibrotic treatment for IPF in the South West Peninsula & Exeter ILD service – a real world study

Thorax, 2021-02, Vol.76 (Suppl 1), p.A161-A161 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. ;2021 Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 0040-6376 ;EISSN: 1468-3296 ;DOI: 10.1136/thorax-2020-BTSabstracts.280

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  • Title:
    P135 Maintenance of antifibrotic treatment for IPF in the South West Peninsula & Exeter ILD service – a real world study
  • Author: Lines, SJ ; Nancarrow, T ; Carbillido Romero, B ; Mandizha, J ; Gibbons, MA
  • Subjects: Patients
  • Is Part Of: Thorax, 2021-02, Vol.76 (Suppl 1), p.A161-A161
  • Description: IPF is a life-limiting condition with an average prognosis of three years from diagnosis. The two anti-fibrotic therapies that are available, Pirfenidone and Nintedanib, can help slow progression of fibrosis and prolong life, but can have significant and often intolerable side effects. Persistence on these anti-fibrotic treatments can be difficult for patients. In order to maximise patient tolerance, regular input from healthcare professionals is required, and this contact needs to be optimised.Anti-fibrotic prescribing data from 2011 until 2019 was analysed retrospectively. Cases were included only where a complete data set was available. We included patient age, referring hospital, start and stop dates of treatment and reasons for discontinuation. We analysed the duration patients are maintained on treatment, the primary reasons for stopping treatment and whether there are any variations across the region.Complete data was analysed for 249 patients prescribed antifibrotics, with first line treatment of 107 patients on Pirfenidone and 142 on Nintedanib. The data shows a clear patient preference for Nintedanib. Average duration of treatment was 497 days for Pirfenidone and 397 days for Nintedanib, with the longest use at 2817 days on Pirfenidone and 2413 days on Nintedanib.Reasons for discontinuation of anti-fibrotic therapy were in keeping with known side effects. Overall, 27% of patients stopped therapy within the first 6 months of treatment, in line with current literature. There was significant variation across the region, ranging from 21% to 38% at different hospitals. This appears to correlate with the availability of additional nurse specialist support in each area.Support from healthcare professionals with ILD expertise appears to be of major importance in maintaining patients on anti-fibrotic therapy. This should be a proactive interaction, initiated by the healthcare provider, rather than the patient. According to our data, optimal timing of these interventions may vary between therapy, with the first 6 months being key in Pirfenidone usage, but the first 12 months being key in Nintedanib usage. Adequate ILD staffing levels are critical to sustain therapy and to implement improvements in treatment.
  • Publisher: London: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0040-6376
    EISSN: 1468-3296
    DOI: 10.1136/thorax-2020-BTSabstracts.280
  • Source: Alma/SFX Local Collection
    ProQuest Central
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