Tae Iwasawa MD, PhD, Presenter: Nothing to Disclose

Takashi Ogura MD, Abstract Co-Author: Nothing to Disclose

Takahiro Endo MD, Abstract Co-Author: Nothing to Disclose

Tomohisa Baba MD, Abstract Co-Author: Nothing to Disclose

Toshiyuki Gotoh PhD, Abstract Co-Author: Nothing to Disclose

Tomio Inoue MD, PhD, Abstract Co-Author: Nothing to Disclose

Pirfenidone is a new anti-fibrotic drug for idiopathic pulmonary fibrosis (IPF), and is reported to halt further fall in the pulmonary function test. There are no reports on CT changes after pirfenidone treatment. We analyzed serial CTs taken after one-year pirfenidone treatment and evaluated its effect on pulmonary fibrosis.

The subjects were 66 patients with IPF in whom two CTs were obtained with one-year interval; including 26 consecutive patients (19 males, 7 females; mean age, 70.1±7.9, ±SD) treated with pirfenidone and 40 age-matched control (28 males, 12 females; age, 68.1±8.3). The initial VC (%pred) was 73.3±13.6%pred for the pirfenidone group and 74.7±16.6 %pred for the controls (p=NS). The pattern of usual interstitial pneumonia was confirmed histopathologically in surgical biopsies from 19 patients on pirfenidone and 29 controls. Corticosteroids and/or immunosuppressants were used by 10 pirfenidone patients and 15 controls. We analyzed the initial and follow-up CT findings quantitatively using computer-based system by determining the volumes with normal pattern (N), fibrous pattern (F), consolidation (C), emphysema (E) and ground glass pattern (G). These volumes were expressed as ratios to predicted total lung capacity (%predTLC) calculated with sex, age and height at each CT examination. We then calculated the change in each volume per year and compared these parameters between the two groups using ANOVA.

The one-year decline in the VC in the pirfenidone group (-3.3±6.5 %pred) was significantly smaller than the control (-12.9±14.4 %pred, p=0.01). There was no significant difference in the initial F-pattern volume between the two groups (13.8±4.1 vs 12.3±3.5 %predTLC, respectively).The change in the F-pattern volume in the pirfenidone group (0.40±2.2 %predTLC) was significantly smaller than the control (1.84±2.1 %predTLC, p=0.01).

Quantitative CT analysis indicated that pirfenidone suppresses fibrosis.

Pirfenidone is a new anti-fibrotic drug for idiopathic pulmonary fibrosis. Quantitative CT analysis showed that pirfenidone suppresses pulmonary fibrosis in patients with IPF.

Iwasawa, T, Ogura, T, Endo, T, Baba, T, Gotoh, T, Inoue, T, CT Evidence of Pirfenidone-induced Suppression of Pulmonary Fibrosis in Patients with Idiopathic Pulmonary Fibrosis.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007392.html