First-of-its-kind study finds a treatment effective for rheumatoid arthritis patients with lung disease (Esbriet (Pirfenidone))

Medical Xpress / National Jewish Health / The Lancet Respiratory Medicine ^ | Sept. 22, 2022 | Joshua J Solomon et al

[ConservativeMind]

For the first time, researchers have shown that a class of anti-fibrotic drugs slows the progression of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA). Research showed that pirfenidone was safe and effective in these patients.

"ILD is a relatively common complication in people with RA and can progress and lead to premature death in up to 10% of these patients," said Joshua Solomon, MD. "This research is a big step forward for patients suffering from RA-ILD."

Rheumatoid arthritis (RA) is one of the most common autoimmune diseases in the world. The treatment for Rheumatoid Arthritis and Interstitial Lung Disease 1 (TRIAL1) was a randomized, double blind, placebo-controlled phase 2 trial done in 34 academic centers specializing in ILD across four countries. Patients with RA-ILD were treated for 52 weeks with either pirfenidone, an anti-scarring medication, or a placebo. The COVID-19 pandemic prevented trial participant enrollment goals from being reached, but the results showed that pirfenidone was safe, well tolerated and slowed down the rate of progression of lung fibrosis over a year.

This was the first and only prospective multi-centered international interventional treatment trial focused on RA-ILD. While the trial was foreshortened because of recruitment challenges during the pandemic, the intervention appeared safe and in context, slowed the rate of forced vital capacity (FVC) decline. As FVC decline is associated with early mortality, slowing the decline may be associated with longer life.

"With this study, we are demonstrating that anti-fibrotics as a class of medications have a reproducible effect in reducing the rate of disease progression when measured by force vital capacity," said Dr. Ivan. "This could have an impact on the overall survival of these patients."

[ConservativeMind]

An option is now available to help slow interstitial lung disease in rheumatoid arthritis patients.

[ConservativeMind]

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