Antifibrotic treatment adherence, efficacy and outcomes for patients with idiopathic pulmonary fibrosis in Spain: a real-world evidence study Romero Ortiz, Ana Dolores Jiménez Rodríguez, Beatriz María López-Ramírez, Cecilia López- Bauzá, Ángela Pérez- Morales, María Delgado-Torralbo, José Antonio Villalba Moral, Cristina Alcázar-Navarrete, Bernardino Background Idiopathic pulmonary fibrosis (IPF) is a rare disorder associated with increased mortality and morbidity. There are currently two drugs approved for IPF but their safety and efficacy profile in real-world settings in Spain is not well understood. Methods An observational, multicentre, prospective study was carried out among patients with IPF who started treatment with pirfenidone or nintedanib from 2015 to 2021. Data regarding clinical characteristics, drug adherence, safety profiles and clinical outcomes between these two drugs were collected. Results 232 patients were included in the analysis. There were no meaningful differences between both groups at baseline. Patients who started pirfenidone showed a decreased risk for treatment withdrawal compared with those starting nintedanib (HR 0.65 (95% CI 0.46 to 0.94; p=0.002)). Time to first adverse event and all-cause mortality was similar between study groups. Risk factors for withdrawal were female sex, diarrhoea and photosensitivity. Conclusions in this real-world study, both pirfenidone and nintedanib showed similar efficacy profiles. Pirfenidone was associated with less treatment discontinuations due to side effects. 2024-09-05T07:48:35Z 2024-09-05T07:48:35Z 2024-04-24 journal article Romero Ortiz, A.D. et. al. 2024;11:e001687. [https://doi.org/10.1136/bmjresp-2023-001687] https://hdl.handle.net/10481/93967 10.1136/bmjresp-2023-001687 eng http://creativecommons.org/licenses/by-nc/4.0/ open access Atribución-NoComercial 4.0 Internacional BMJ Publishing Group