Indirect meta-analysis of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis
- VernacularTitle:吡非尼酮和尼达尼布治疗特发性肺纤维化的间接Meta分析
- Author:
Jia WANG
1
;
Shuyue LI
2
;
Suxin QU
1
;
Hao WANG
3
;
Weihong GE
3
Author Information
1. Dept. of Pharmacy，Qingdao Women and Children’s Hospital of Qingdao University，Shandong Qingdao 266011，China
2. Dept. of Pharmacy，Shanxi Provincial Cancer Hospital，Taiyuan 030000，China
3. Dept. of Pharmacy，the Affiliated Drum Tower Hospital of Nanjing University Medical School，Nanjing 210008，China
- Publication Type:Journal Article
- Keywords:
pirfenidone;
nintedanib;
idiopathic pulmonary fibrosis;
efficacy;
safety;
indirect meta-analysis
- From:
China Pharmacy
2022;33(23):2901-2907
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the clinical efficacy and safety of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis. METHODS Randomised controlled trials on pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis which were publicly published in Chinese and English were searched from CNKI， Wanfang， VIP， PubMed， Cochrane library and other databases. The search time was set from January 2000 to December 2021. The existing studies were combined with indirect meta-analysis to systematically evaluate the efficacy and safety of the two drugs in the treatment of idiopathic pulmonary fibrosis. RESULTS A total of 15 randomized controlled trials were included， involving 1 026 cases in trial group of pirfenidone and 845 cases in control group of pirfenidone， 1 846 cases in trial group of nintedanib and 1 848 cases in control group of nintedanib. Both control groups were placebo. The results of indirect meta-analysis showed that the two drugs were similar in the evaluation indicators of therapeutic efficacy as acute exacerbation rate， the incidence of forced vital capacity （FVC）% decrease ≥10% from baseline or the incidence of absolute value decrease ≥0.2 L （P values of indirect analysis results were all ＞ 0.01， and the difference was not statistically significant）； but in terms of disease progression rate， nintedanib 150 mg （bid） was superior to pirfenidone 800 mg （tid） （RR＝1.66， 95%CI＝1.06-2.63）； in terms of safety， the incidence of diarrhea induced by nintedanib 150 mg （bid） was higher than pirfenidone 800 mg （tid） （RR＝0.42， 95%CI＝0.33-0.53）. CONCLUSIONS Compared with pirfenidone， nintedanib has slightly superior efficacy in terms of disease progression control， but the incidence of adverse reactions is also increased.
