Comparing the Utilization of Antifibrotic Medications Based on Income Level.

The antifibrotic medications pirfenidone and nintedanib have transformed the treatment landscape for patients with idiopathic pulmonary fibrosis (IPF) since their approval in 2014 after randomized controlled trials showing the medications slowed the decline in lung function compared with placebo. 1 King Jr., T.E. Bradford W.Z. Castro-Bernardini S. et al. ASCEND Study Group: a phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N Engl J Med. 2014; 370: 2083-2092 Crossref PubMed Scopus (2597) Google Scholar ,2 Richeldi L. du Bois R.M. Raghu G. et al. INPULSIS Trial Investigators: efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med. 2014; 370: 2071-2082 Crossref PubMed Scopus (2939) Google Scholar Data from pooled meta-analyses and observational studies have also demonstrated that the medications may reduce the risk of mortality and hospitalization for patients with IPF, helping supplement the clinical trials with real world results. 3 Rogliani P. Calzetta L. Cavalli F. Matera M.G. Cazzola M. Pirfenidone, nintedanib and N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Pulm Pharmacol Ther. 2016; 40: 95-103 Crossref PubMed Scopus (101) Google Scholar , 4 Dempsey T.M. Sangaralingham L.R. Yao X. Sanghavi D. Shah N.D. Limper A.H. Clinical effectiveness of antifibrotic medications for idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2019; 200: 168-174 Crossref PubMed Scopus (83) Google Scholar , 5 Petnak T. Lertjitbanjong P. Thongprayoon C. Moua T. Impact of antifibrotic therapy on mortality and acute exacerbation in idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Chest. 2021; 160: 1751-1763 Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar