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Updated: Dec 25, 2025

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Pirfenidone in chronic lung allograft dysfunction: a single cohort study.

David Bennett1, Nicola Lanzarone2, Antonella Fossi2

  • 1Unit of Respiratory Diseases, Department of Medical Sciences, University Hospital of Siena, Siena, Italy - david.btt@gmail.com.

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Pirfenidone, an antifibrotic drug, demonstrated a good safety profile in chronic lung allograft dysfunction (CLAD) patients. It may help stabilize respiratory function decline, but further research is needed to confirm its effectiveness.

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Area of Science:

  • Pulmonology
  • Transplantation Medicine
  • Pharmacology

Background:

  • Chronic lung allograft dysfunction (CLAD) is the primary cause of long-term mortality post-lung transplant.
  • Pirfenidone, an antifibrotic medication approved for idiopathic pulmonary fibrosis (IPF), has been investigated for CLAD treatment.
  • This study aimed to assess pirfenidone's safety and efficacy in CLAD patients.

Purpose of the Study:

  • To evaluate the safety profile of pirfenidone in patients diagnosed with CLAD.
  • To explore the potential efficacy of pirfenidone in managing CLAD progression.
  • To analyze survival rates and respiratory function changes in CLAD patients treated with pirfenidone.

Main Methods:

  • A retrospective analysis of nine CLAD patients treated with pirfenidone.
  • Pulmonary function tests (PFTs) were conducted pre- and post-treatment.
  • Adverse events and survival data were collected and analyzed.

Main Results:

  • Pirfenidone treatment showed a good safety profile, with significant side effects in only one patient.
  • A notable reduction in the rate of FEV1 decline was observed in patients receiving pirfenidone.
  • Median survival was 686 days overall and 221 days from the start of pirfenidone therapy, with no significant difference based on CLAD phenotype.

Conclusions:

  • Pirfenidone exhibits a favorable safety profile in CLAD patients, comparable to IPF patients.
  • The drug shows potential in stabilizing the decline of respiratory function in CLAD.
  • Further extensive studies are required to definitively establish pirfenidone's effectiveness for CLAD treatment.