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Evaluation of bosentan for idiopathic pulmonary fibrosis

Jeffrey J Swigris1, Kevin K Brown

  • 1Interstitial Lung Disease Program, National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO, USA. swigrisj@njc.org

Expert Review of Respiratory Medicine
|May 19, 2010
PubMed

Insights

Idiopathic pulmonary fibrosis (IPF) is a severe lung disease with poor survival. Bosentan, an endothelin receptor antagonist, showed no overall benefit in a recent IPF trial but may benefit a specific patient subgroup.

Area of Science:

  • Pulmonology
  • Pharmacology
  • Fibrotic lung diseases

Background:

  • Idiopathic pulmonary fibrosis (IPF) is a progressive, life-limiting lung disease with a median survival of approximately 3 years.
  • Current therapeutic options for IPF are limited, highlighting the need for novel treatment strategies.
  • Endothelin-1 and fibrogenic cytokines are implicated as potential molecular targets in IPF pathogenesis.

Purpose of the Study:

  • To evaluate the efficacy of bosentan, a nonselective endothelin receptor antagonist, as a potential therapy for idiopathic pulmonary fibrosis (IPF).

Main Methods:

  • A multinational, placebo-controlled clinical trial was conducted to assess bosentan's impact on IPF.
  • The trial's primary endpoint was evaluated, and a post hoc analysis identified a specific subgroup for further assessment.
  • The selected subgroup comprised patients with biopsy-proven IPF and minimal radiographic honeycombing.

Main Results:

  • The primary endpoint of the multinational trial did not demonstrate a beneficial impact of bosentan in patients with IPF.
  • A post hoc analysis suggested potential efficacy in a selected subgroup of IPF patients.
  • Results from the ongoing assessment in this subgroup are anticipated.

Conclusions:

  • Bosentan did not show overall efficacy in the studied IPF patient population.
  • Further investigation is warranted to determine the potential benefit of bosentan in specific IPF subgroups, such as those with biopsy-proven disease and limited honeycombing.

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