Decision for pirfenidone and nintedanib: For patients with mild or moderate IPF based on pulmonary function tests who do not have underlying liver disease
-Current data are insufficient to direct a firm choice between pirfenidone and nintedanib,
-diarrhea and liver function test abnormalities with nintedanib versus nausea and rash with pirfenidone
2. Nintedanib & Pirfenidone comparison slide
3. Counseling: Neither medication offers more than possible slowing of progression of disease or improvement in dyspnea on exertion
4. Neither medication has been tested in advanced disease or in patients with pulmonary hypertension
5. Drug therapy research trials are still available (taking pirfenidone or nintedanib may not exlude patients from these studies)
Nintedanib (Ofev)
- General: https://www.ofev.com/
- General prescriber info:
- Patient consent for resources: (patient signature required)
- Monitoring: Conduct liver function tests (ALT, AST, and bilirubin) prior to treatment with OFEV, monthly for 3 months, and every 3 months thereafter, and as clinically indicated. Dosage modifications, interruption, or discontinuation may be necessary for liver enzyme elevations.
- Other side effects: diarrhea (smoking may decrease systemic exposure to medication), see website for more details
- Patient support/finance: https://www.ofev.com/assets/pdf/NIN631216CONS_HUB_Patient_Opt_In_Form.pdf
Pirfenidone (Esbriet)
- General: https://www.esbriethcp.com/
- Prescriber form/patient enrollment in CareConnect: http://www.esbrietcareconnect.com/downloads/Esbriet_Patient_Enrollment_Form.pdf (patient signature required)
- Patient auth form (look into financial assistance): http://www.esbrietcareconnect.com/downloads/Patient_Authorization_Form_English.pdf (patient signature required)
- Other resources: http://www.esbrietcareconnect.com/healthcare-professional/resources/
- Monitoring: Conduct liver function tests (ALT, AST, and bilirubin) prior to initiating Esbriet, then monthly for the first 6 months and every 3 months thereafter. Dosage modifications or interruption may be necessary.
- Other side effects: photosensitivity, diarrhea
- Patient info on initial process: http://www.esbrietcareconnect.com/downloads/Patient_Esbriet_CareConnect_Tear_Sheet.pdf
- Patient info on Esbriet: http://www.esbrietcareconnect.com/downloads/Patient_Esbriet_CareConnect_Brochure.pdf.pdf