两种新型抗纤维化药物治疗特发性肺纤维化的研究进展

王春彬,张爽,张倩,张相林

中国药学杂志 ›› 2019, Vol. 54 ›› Issue (9) : 682-686.

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中国药学杂志
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中国药学杂志 ›› 2019, Vol. 54 ›› Issue (9) : 682-686. DOI: 10.11669/cpj.2019.09.002
综述

两种新型抗纤维化药物治疗特发性肺纤维化的研究进展

  • 王春彬1,2,张爽1,2,张倩1,2,张相林1*
作者信息 +

Research Progress of Two New Antifibrotic Drugs for Idiopathic Pulmonary Fibrosis

  • WANG Chun-bin1,2, ZHANG Shuang1,2, ZHANG Qian1,2, ZHANG Xiang-lin1*
Author information +
文章历史 +

摘要

吡非尼酮与尼达尼布是两种新型的抗纤维化药物,在多个临床试验中证实能够延缓特发性肺纤维化(idiopathic pulmonary fibrosis, IPF)患者肺功能下降速度,是治疗IPF的一线药物。但两种新型抗纤维化药物应如何选择尚缺乏依据,笔者通过查阅近年来国内外相关文献,对吡非尼酮和尼达尼布应用于IPF的药理机制、药动学、临床研究、安全性等信息进行归纳总结并进行比较,以期为临床用药提供参考。研究表明,吡非尼酮与尼达尼布均能减缓轻中度IPF患者肺纤维化的进展及肺功能下降的速度,且可能对重度IPF患者同样有效。两种新型抗纤维化药物在药理作用机制,药动学以及不良反应方面有较大差别,但在疗效方面,尚无明确证据表明哪种药物更佳。临床应基于两种药物的药动学特征以及不良反应特征进行个体化给药。

Abstract

Pirfenidone and nintadanib are two new anti-fibrotic drugs that have been shown to reduce the decline of lung function in patients with idiopathic pulmonary fibrosis (IPF) in multiple clinical trials,and have become first-line drugs for the treatment of IPF.However there are lack of references for how to choose between these two drugs. This article collected the latest research literatures related to pirfenidone or nintedanib,and summarized pharmacokinetics, pharmacological mechanism, clinical trials and safety profile of pirfenidone and nintedanib, so as to provide reference for clinical drug use. Evidences show both pirfenidone and nintedanib can reduce the decline of lung function and delay disease progression in mild-to-moderte IPF patients, and may have similar effects on severe IPF patients. There are large differences in pharmacological mechanisms, pharmacokinetics, and adverse events between these two new antifibrotic drugs. However, in terms of efficacy, there is no clear evidence to show which drug is better. Clinicians choosing drug should base on pharmacokinetic characteristics and adverse events between these two drugs.

关键词

特发性肺纤维化 / 抗纤维化 / 吡非尼酮 / 尼达尼布

Key words

idiopathic pulmonary fibrosis / antifibrotic / pirfenidone / nintedanib

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王春彬,张爽,张倩,张相林. 两种新型抗纤维化药物治疗特发性肺纤维化的研究进展[J]. 中国药学杂志, 2019, 54(9): 682-686 https://doi.org/10.11669/cpj.2019.09.002
WANG Chun-bin, ZHANG Shuang, ZHANG Qian, ZHANG Xiang-lin. Research Progress of Two New Antifibrotic Drugs for Idiopathic Pulmonary Fibrosis[J]. Chinese Pharmaceutical Journal, 2019, 54(9): 682-686 https://doi.org/10.11669/cpj.2019.09.002
中图分类号： R969.4   

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