Ofev and Esbriet: New Treatments for Idiopathic Pulmonary Fibrosis

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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Both Ofev (nintedanib) and Esbriet (pirfenidone) were approved by the FDA on October 15, 2014 for the treatment of idiopathic pulmonary fibrosis (IPF). This is big for anyone suffering from this condition—these are the first two medications to be proven to slow the progression of IPF, which is usually a fatal disease.

First, what is idiopathic pulmoary fibrosis?

Idiopathic pulmonary fibrosis (IPF) is a condition where the tissue in the lungs thickens and turns into scar tissue over time. As the lung tissue thickens, your body, including your brain and other essential organs, is deprived of oxygen. Symptoms include coughing and shortness of breath.

Unfortunately, the underlying cause of this disease is usually unknown. However, exposure to some medications, pollutants, viral infections, or a family history of IPF may increase risk.

What current treatments are available?

At the moment, treatment for IPF includes oxygen therapy, pulmonary rehabilitation, and lung transplant. Some other medications may be prescribed to ease symptoms.

How do Ofev and Esbriet work?
Ofev is a kinase inhibitor that works by blocking several pathways that may be involved in the thickening or scarring of lung tissue.

Esbriet also works on multiple pathways that may be involved in the scarring of lung tissue.

When will Ofev and Esbriet be available?

According to their manufacturers, Ofev was predicted to be available within 10 days of approval, and Esbriet within 2 weeks. Look for them on the market soon.

Is one more effective than the other?
Ofev and Esbriet haven’t been compared to each other in clinicaal trials, but individually, they seem to be similarly effective. You should know that neither is a cure, but both may be options for extending life after a diagnosis of IPF.

Are there advantages to using Ofev over Esbriet?
Ofev may be more convenient. It doesn’t require titration up to the recommended dose like Esbriet, so you can start on the dose you will continue taking. With Esbriet, you will need to start with fewer capsules per dose and work up to the full amount.

Ofev also requires fewer pills per dose and less frequent dosing: the recommended doses are one 150 mg capsule twice daily for Ofev, and three 267 mg capsules three times daily for Esbriet.

What about advantages of using Esbriet over Ofev?
Ofev can cause birth defects or death to an unborn baby and cannot be used in women who are pregnant or expect to become pregnant.

In contrast, Esbriet has not been shown to cause birth defects when studied in animals. However, Esbriet should still only be used in pregnancy if the benefits outweigh the risks since there have not been adequate or well-controlled human studies.

Is there financial assistance available?

Yes. Both Esbriet and Ofev have patient support programs:

Find more information about the Esbriet Care Connect program.

Find more information about the Ofev Open Doors program.

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