Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Geriatrics, Henan Provincial People's Hospital, Zhengzhou, China.
BMJ Open. 2021 Dec 31;11(12):e050004. doi: 10.1136/bmjopen-2021-050004.
Idiopathic pulmonary fibrosis (IPF) has been defined as a distinctive type of chronic fibrotic disease, characterised by a progressive decline in lung function and a common histological pattern of interstitial pneumonia. To analyse the efficacy and safety of pirfenidone in the treatment of IPF, a systematic review and meta-analysis was performed.
This is a meta-analysis study.
Patients were diagnosed as IPF.
Use of pirfenidone.
Progression-free survival (PFS), acute exacerbation and worsening of IPF and Impact on adverse events.
The inverse variance method for the random-effects model was used to summarise the dichotomous outcomes, risk ratios and 95% CIs.
A total of 9 randomised controlled trials with 1011 participants receiving pirfenidone and 912 controls receiving placebo were summarised. The pooled result suggested a statistically significant difference inall-cause mortality after pirfenidone use, with a summarised relative ratio of 0.51 (p<0.01). Longer PFS was observed in patients receiving pirfenidone compared with those who were given placebo (p<0.01). The IPF groups presented a high incidence of adverse events with a pooled relative ratio of 3.89 (p<0.01).
Pirfenidone can provide survival benefit for patients with IPF. Pirfenidone treatment was also associated with a longer PFS, a lower incidence of acute exacerbation and worsening of IPF.
特发性肺纤维化（IPF）已被定义为一种独特的慢性纤维化疾病，其特征是肺功能进行性下降和间质性肺炎的常见组织学模式。为了分析吡非尼酮治疗特发性肺纤维化的疗效和安全性，进行了系统评价和荟萃分析。
这是一项荟萃分析研究。
患者被诊断为特发性肺纤维化。
使用吡非尼酮。
无进展生存期（PFS）、急性加重和特发性肺纤维化恶化以及对不良事件的影响。
采用随机效应模型的逆方差法对二分类结局进行汇总，计算风险比和 95%置信区间。
共纳入 9 项随机对照试验，1011 例患者接受吡非尼酮治疗，912 例患者接受安慰剂治疗。汇总结果表明，使用吡非尼酮后全因死亡率存在统计学差异，汇总相对比为 0.51（p<0.01）。与安慰剂组相比，接受吡非尼酮治疗的患者 PFS 更长（p<0.01）。特发性肺纤维化组不良事件发生率较高，汇总相对比为 3.89（p<0.01）。
吡非尼酮可为特发性肺纤维化患者提供生存获益。吡非尼酮治疗还与更长的 PFS、更低的急性加重和特发性肺纤维化恶化发生率相关。
