FRIDAY, May 23 (HealthDay News) -- Patients with a progressive
fibrosis of the lungs that's fatal within a few years of diagnosis
may finally have some reason for hope.
Japanese researchers say daily use of the drug pirfenidone
improved the lung function and lengthened the survival of patients
with the illness, called idiopathic pulmonary fibrosis (IPF).
"Patients look to any research in IPF with a sense of hope,
because right now, there's very little that can be done for them,"
said Mark Shreve, founder and chief operating officer of the
Coalition for Pulmonary Fibrosis, based in San Jose, Calif.
"To say that there's a desperate need -- even that would be an
incredible understatement, because you are talking about a
devastating, relentless disease that has a survival rate of less
than three years, and no proven cause and no treatment," he
said.
But the results of the new phase III clinical trial, involving
275 Japanese patients with mild-to-moderate IPF, may change all
that. The findings were presented this week at the annual meeting
of the American Thoracic Society, in Toronto.
According to Shreve, 128,000 Americans are battling IPF at any
given time. Each year, 48,000 new cases are diagnosed, and 40,000
people die from the illness -- equal to the annual death toll from
breast cancer.
IPF's origins remain largely unknown. It typically arises in
late middle-age or the senior years and involves a progressive
fibrosis: a process in which healthy lung tissue turns into useless
scar tissue. This hardening of the lungs gradually and relentlessly
robs patients of their ability to breathe.
"There's no drug, period, that's ever been approved for IPF,"
Shreve said. "Right now, the only treatment option that's been
shown to extend the lives of patients is a lung transplant. But,
other than that, the disease itself is an incredibly progressive,
severe relentless disease."
That's why the results of the new trial have generated a level
of cautious excitement among the IPF research community. In the
study, a team led by Dr. Takashi Ogura, of Kanagawa Cardiovascular
and Respiratory Center, Yokohama, gave patients either high-dose
(1,800 milligrams) or low-dose (1,200 milligrams) pirfenidone or a
placebo each day. Then they tracked changes in lung capacity,
disease progression and patient survival over the course of a
year.
Ogura's team reported that patients on high-dose pirfenidone
achieved significantly less deterioration in lung capacity compared
to those not on the drug. Those placed on the medication also
displayed a slowdown in disease progression. Side effects included
skin rash and loss of appetite.
"Taken together, our study demonstrated positive clinical
effects of pirfenidone that suppresses the progress of IPF and
potentially contributes to improving the outcomes of patients with
IPF," Ogura said in a prepared statement.
Pirfenidone is "a drug in its own class," explained Dr. Ganesh
Raghu, director of the Interstitial Lung Disease/Sarcoid/Pulmonary
Fibrosis Program at the University of Washington Medical Center, in
Seattle. His team pioneered the use of pirfenidone -- which is
thought to have anti-inflammatory and anti-fibrotic properties --
against IPF more than a decade ago.
"It has taken this long -- 11, 12 years -- for it to reach the
stage of phase III. I'm quite pleased that a drug of potential
efficacy or anti-fibrotic effect is used for IPF. The Japanese
trial is encouraging," said Raghu, who is also professor of
pulmonary and critical care medicine at the University of
Washington.
Still, he stressed that the population used in the Japanese
trial may not represent the full spectrum of IPF patients, so it's
too early to tell if pirfenidone will work for everyone with the
disease. A larger, multi-center trial using the drug is currently
under way in Europe and North America, with results expected later
this year.
"Until further studies that enroll large number of patients and
include all spectrum of patients with IPF, we cannot extrapolate
the findings to the entire patient population with IPF," Raghu
said.
He also cautioned that pirfenidone has not yet been approved for
use against any medical condition by the U.S. Food and Drug
Administration, meaning that IPF patients can only get the medicine
by participating in a clinical trial.
And while pirfenidone may slow the progression of IPF, it does
not stop it, Shreve noted.
"If this drug works out, that's fantastic, but it's still not a
cure," Shreve said. "With a cure -- that's when we'll be really
excited."
More information
To learn more about IPF, visit the
Coalition
for Pulmonary Fibrosis.