Hagmeyer Lars, Treml Marcel, Priegnitz Christina, Randerath Winfried J
Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital, Solingen, Germany.
Respiration. 2016;91(4):327-32. doi: 10.1159/000444690. Epub 2016 Apr 14.
Pirfenidone and nintedanib are both pleiotropic anti-fibrotic agents approved for the treatment of idiopathic pulmonary fibrosis (IPF) as monotherapy. To date, evidence supporting their efficacy as concomitant therapy has not been reported. Here, we present the first case of a Caucasian male patient with IPF treated with both pirfenidone and nintedanib following 2 years of treatment with pirfenidone monotherapy. Over a 24-month period, there was a clear decline in the patient's forced vital capacity from 3.5 liter before initiation of treatment to 2.5 liter after 24 months. Concomitant nintedanib treatment was initiated in March 2015. Lung function stabilized, and the two treatments were well tolerated. Treatment with pirfenidone and nintedanib has currently been ongoing for nearly 12 months. This is the first report of a successful long-term treatment with pirfenidone and nintedanib and suggests that in selected cases, concomitant anti-fibrotic therapy may represent a safe and therapeutically valuable escalation option after pirfenidone monotherapy.
吡非尼酮和尼达尼布都是多效性抗纤维化药物，已被批准作为单一疗法用于治疗特发性肺纤维化（IPF）。迄今为止，尚无支持它们作为联合疗法有效性的证据报道。在此，我们报告首例接受吡非尼酮单一疗法治疗2年后，同时使用吡非尼酮和尼达尼布治疗的白种男性IPF患者。在24个月的时间里，患者的用力肺活量从治疗开始前的3.5升明显下降至24个月后的2.5升。2015年3月开始联合使用尼达尼布治疗。肺功能稳定，两种治疗的耐受性良好。目前，吡非尼酮和尼达尼布联合治疗已持续近12个月。这是首例关于吡非尼酮和尼达尼布成功长期治疗的报告，表明在某些特定病例中，联合抗纤维化治疗可能是吡非尼酮单一疗法后一种安全且具有治疗价值的升级选择。
