Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysis

This updated systematic review and meta-analysis pooled the results of previous clinical trials assessing the effects of pirfenidone and nintedanib on patients with pulmonary fibrosis. Scopus, the Cochrane Library, PubMed, and Web of Science were searched from the inception to April 12, 2025, to ide...

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Main Authors: Yiting Qiu, Wei Ye
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:Annals of Thoracic Medicine
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Online Access:https://journals.lww.com/10.4103/atm.atm_132_25
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author Yiting Qiu
Wei Ye
author_facet Yiting Qiu
Wei Ye
author_sort Yiting Qiu
collection DOAJ
description This updated systematic review and meta-analysis pooled the results of previous clinical trials assessing the effects of pirfenidone and nintedanib on patients with pulmonary fibrosis. Scopus, the Cochrane Library, PubMed, and Web of Science were searched from the inception to April 12, 2025, to identify randomized controlled trials measuring the effect of pirfenidone and nintedanib on pulmonary fibrosis. Because of high methodological heterogeneity, we utilized a random-effects model (DerSimonian-Laird) to perform this meta-analysis. Finally, 18 articles with 20 randomized controlled trials were included in this meta-analysis. We found that compared to placebo, treatment with the two antifibrotic drugs increased forced vital capacity (FVC) predicted (weighted mean difference [WMD] 3.12%, 95% confidence interval [CI] [1.41, 4.82], I2 = 53.30%), FVC volume (WMD 87.44 ml, 95% CI [59.32, 115.57], I2 = 99.4%), and the distance walked in the 6-minute walk test (WMD 24.63 m, 95% CI [16.05, 33.22], I2 = 0.00%). However, compared to placebo, treatment with the two antifibrotic drugs did not significantly change the diffusing capacity of the lungs for carbon monoxide (WMD 1.38 ml/min/mmHg, 95% CI [−9.42, 12.18], I2 = 0.00%). Therapeutic benefits were observed for both pirfenidone and nintedanib and for both idiopathic pulmonary fibrosis (IPF) and non-IPF. Pirfenidone and nintedanib can improve lung function and functional capacity in patients with different types of pulmonary fibrosis.
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spelling doaj-art-eed3344824824b1eb8a7ebecbfdffe4e2025-08-20T03:39:54ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572025-07-0120314515210.4103/atm.atm_132_25Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysisYiting QiuWei YeThis updated systematic review and meta-analysis pooled the results of previous clinical trials assessing the effects of pirfenidone and nintedanib on patients with pulmonary fibrosis. Scopus, the Cochrane Library, PubMed, and Web of Science were searched from the inception to April 12, 2025, to identify randomized controlled trials measuring the effect of pirfenidone and nintedanib on pulmonary fibrosis. Because of high methodological heterogeneity, we utilized a random-effects model (DerSimonian-Laird) to perform this meta-analysis. Finally, 18 articles with 20 randomized controlled trials were included in this meta-analysis. We found that compared to placebo, treatment with the two antifibrotic drugs increased forced vital capacity (FVC) predicted (weighted mean difference [WMD] 3.12%, 95% confidence interval [CI] [1.41, 4.82], I2 = 53.30%), FVC volume (WMD 87.44 ml, 95% CI [59.32, 115.57], I2 = 99.4%), and the distance walked in the 6-minute walk test (WMD 24.63 m, 95% CI [16.05, 33.22], I2 = 0.00%). However, compared to placebo, treatment with the two antifibrotic drugs did not significantly change the diffusing capacity of the lungs for carbon monoxide (WMD 1.38 ml/min/mmHg, 95% CI [−9.42, 12.18], I2 = 0.00%). Therapeutic benefits were observed for both pirfenidone and nintedanib and for both idiopathic pulmonary fibrosis (IPF) and non-IPF. Pirfenidone and nintedanib can improve lung function and functional capacity in patients with different types of pulmonary fibrosis.https://journals.lww.com/10.4103/atm.atm_132_256-min walk testforced vital capacitymeta-analysisnintedanibpirfenidonepulmonary fibrosis
spellingShingle Yiting Qiu
Wei Ye
Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysis
Annals of Thoracic Medicine
6-min walk test
forced vital capacity
meta-analysis
nintedanib
pirfenidone
pulmonary fibrosis
title Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysis
title_full Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysis
title_fullStr Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysis
title_full_unstemmed Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysis
title_short Therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis; a systematic review and meta-analysis
title_sort therapeutic efficacy of pirfenidone and nintedanib in pulmonary fibrosis a systematic review and meta analysis
topic 6-min walk test
forced vital capacity
meta-analysis
nintedanib
pirfenidone
pulmonary fibrosis
url https://journals.lww.com/10.4103/atm.atm_132_25
work_keys_str_mv AT yitingqiu therapeuticefficacyofpirfenidoneandnintedanibinpulmonaryfibrosisasystematicreviewandmetaanalysis
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