Meta-Analysis on Efficacy and Adverse Reactions of Pirfenidone in Idiopathic Pulmonary Fibrosis

Abstract

Abstract: Objective To systematically assess the efficacy and adverse reactions of pirfenidone in patients with idiopathic pulmonary fibrosis (IPF) by meta-analysis. Methods Randomized controlled trials using pirfenidone as an intervention to treat IPF published from 1999 to 2022 were searched in PubmedWeb Of Science, CNKI, WanFang database and VIP database. Methodological quality evaluation and statistical analysis were conducted using Review Manager 5.3 provided by the Cochrane Collaboration. Results 13 clinical trials,involving 2088 patients, met the inclusion. The improvement of forced vital capacity (FVC), the main index of lung function, was significantly higher in pirfenidone group than in control group[SMD=1.03, 95%CI (0.81, 1.24), P<0.001]. And most of the secondary indexes, such as the change of FEV₁ [SMD=0.96,95%CI (0.77, 1.16),P<0.001], the change of DLCO[SMD=0.30, 95%CI (0.09, 0.51, P=0.005]and the change of PaO₂[SMD=0.57, 95%CI (0.28,0.86), P<0.001], were statistically significant; the incidence of rash between pirfenidone group and control group was statistically significant[RR=2.81, 95%CI (2.17, 3.65), P<0.001]. The incidence of adverse reactions including dizziness [RR=1.59, 95%CI (1.21,2.09), P<0.001], gastrointestinal reaction [RR=1.87,95%CI (1.65,2.12), P<0.001] were compared with the control group. Conclusion Pirfenidone can delay the decline of pulmonary function in patients with idiopathic pulmonary interstitial fibrosis and slow the progression of the disease. Adverse reactions are common, and they are mild and can be tolerated by patients.

Key words: pirfenidone, IPF, efficacy, adverse reaction, meta-analysis

CLC Number:

R563

YANG Jian, LUO Qian-qian, LI Tao, WANG Ze-ning, WANG Shou-shou, JIANG Zhan-shi, LIU Shu-ying, DONG Jiu-wei. Meta-Analysis on Efficacy and Adverse Reactions of Pirfenidone in Idiopathic Pulmonary Fibrosis[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(16): 65-70.

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