At the most recent American Lung Association LUNGFORCE expo, RDR sat down with Albert Rizzo, M.D. of the Christiana Care Pulmonary and Critical Care Medicine Section to discuss previous, current and emerging therapies for idiopathic pulmonary fibrosis.
Rizzo: We thought that it was an inflammatory process, and the drugs that were often used in the past included oral corticosteroids – one of the common ones was prednisone. Also drugs azathioprine or imuran were used. There was also an entity N-acetylcysteine, or NAC. For many years, patients were being put on those drugs to help control their symptoms. Fortunately, a few years ago, a good clinical study was done that showed that those three drugs, in particular, actually made patients worse. So, we now know that that’s not the way to go, and, fortunately, we have other drugs that have come to market that make a difference, as far as slowing down the disease process, and as far as that fibrosis.
In 2014, two drugs were approved by the FDA, almost on the same day – Ofev and Esbriet. Ofev is considered a tyrosine kinase inhibitor, so it works through a number of different enzymes in the lung that we know are important in regard to fibrosis and healing. Esbriet, it’s not really known exactly how it works, but we know that, from the clinical trials that were done for both of those drugs, each of those drugs had clinical trials done to show that they slow down the progression of the disease. That’s what led to the FDA allowing approval of those agents to be used.
Fortunately, I was just at a lecture where they probably talked about over 50 clinical trials that can be seen on clinicaltrial.gov, which are in that group of emerging therapies. Patients with IPF, and patients with any condition for that matter, like lung cancer, should seek out clinical trials. It may benefit them, as well as potentially benefitting others if those trials end up displaying good efficacy for the drugs that are being used.
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