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Pirfenidone and Nintedanib Compliance and Persistence in A Real World Setting

This study analyzed real-world data on patient compliance and persistence with pirfenidone and nintedanib, two drugs approved to treat idiopathic pulmonary fibrosis. The study included over 2,300 patients initiating treatment between 2014-2016. Results showed that 28.1% of patients discontinued treatment overall, but discontinuation was lower for pirfenidone (23.8%) than nintedanib (33.5%). Among those who continued treatment, compliance as measured by medication possession ratio and proportion of days covered was also higher for pirfenidone. This is the first real-world study to examine adherence and persistence with anti-fibrotic therapies for pulmonary fibrosis.

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88 views2 pages

Pirfenidone and Nintedanib Compliance and Persistence in A Real World Setting

This study analyzed real-world data on patient compliance and persistence with pirfenidone and nintedanib, two drugs approved to treat idiopathic pulmonary fibrosis. The study included over 2,300 patients initiating treatment between 2014-2016. Results showed that 28.1% of patients discontinued treatment overall, but discontinuation was lower for pirfenidone (23.8%) than nintedanib (33.5%). Among those who continued treatment, compliance as measured by medication possession ratio and proportion of days covered was also higher for pirfenidone. This is the first real-world study to examine adherence and persistence with anti-fibrotic therapies for pulmonary fibrosis.

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maleticj
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C37 NEW INSIGHTS IN THE EPIDEMIOLOGY, MANAGEMENT, AND OUTCOMES OF CYSTIC FIBROSIS, ILD, AND RESPIRATORY DISEASE / Thematic

Poster Session / Tuesday, May


23/9:15 AM-4:15 PM / Area B, Hall B-C (Middle Building, Lower Level) Walter E. Washington Convention Center

Pirfenidone And Nintedanib Compliance And Persistence In A Real World Setting

D. Lalla1, L. Bengston2, K. Raimundo1, S. Korrer2, D. Liassou2, C. Elliott2, S. L. Limb1


1Genentech, Inc., South San Francisco, CA, 2OPTUM, Eden Prairie, MN

Rationale: In October 2014, pirfenidone and nintedanib were approved for the treatment of idiopathic pulmonary fibrosis. Limited
real-world data are available on patients’ compliance and persistence with these anti-fibrotic medications.
Methods: Commercial and Medicare Advantage pharmacy plan enrollees ≥40 years old initiating treatment with pirfenidone or
nintedanib between 10/01/2014-03/31/2016 were identified from the Optum Research Database. Patients had ≥6 months of continuous
enrollment prior to the index date and ≥30 days following the index date, unless death occurred <30 days post index. Patients with
prescription fills for pirfenidone and nintedanib were excluded. Compliance was assessed with the medication possession ratio (MPR) and
the proportion of days covered (PDC); dose titration was not considered in these calculations. MPR was calculated by summing the
number of days supplied of the index medication for all but the last fill in the observation period, divided by the number of days between
the first and the last refill. PDC was calculated by dividing the number of days on which medication was available by the total days of
follow up. Discontinuation was defined as a treatment gap of ≥60 days after the run out of days’ supply, and time to discontinuation was
defined as the time in days from the index date until discontinuation.
Results: The study population included 2,331 patients initiating an anti-fibrotic medication (pirfenidone: n=1,291; nintedanib: n = 1,040).
The mean age of patients in the pirfenidone and nintedanib cohort was 74.7±7.0 and 74.7±7.3, respectively. There were significantly fewer
females in the pirfenidone cohort vs. nintedanib cohort (34.2% vs. 40.3%; p=0.002). Overall, 28.1% of patients discontinued treatment; in
the pirfenidone cohort 23.8% of patients discontinued treatment, while 33.5% of patients in the nintedanib cohort discontinued (p<0.001;
Table). Among patients who discontinued, the mean time to discontinuation was 108 days for pirfenidone vs. 91 days for nintedanib
patients, p=0.009. Among patients who did not discontinue, the mean number of index prescription fills was significantly higher among
the pirfenidone cohort compared to the nintedanib cohort (8.05±4.63 vs. 7.06±4.72; p<0.001). Similar results were observed among
patients who discontinued. Differences in MPR and PDC were observed (MPR: pirfenidone: 0.90±0.15 vs. nintedanib: 0.92±0.14, p<0.001;
PDC: pirfenidone: 0.76±0.28 vs. nintedanib: 0.71±0.32, p<0.001).
Conclusions: This is the first real-world study of adherence and persistence with anti-fibrotic therapies. Fewer patients on pirfenidone
discontinued therapy during follow up. Future studies will build on these descriptive results with multivariable analyses.

This abstract is funded by: Genentech, Inc. and F. Hoffmann-La Roche Ltd.
Am J Respir Crit Care Med 2017;195:A5351
Internet address: www.atsjournals.org Online Abstracts Issue

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