Two new drugs for the treatment of pulmonary fibrosis have been approved by the FDA. You may recall from previous discussions that pulmonary fibrosis is a disease of scarring that occurs in the lung tissue. The scarring effect can be due to other diseases such as rheumatoid arthritis, or drugs like amiodarone, or chronic aspiration of acid in patients with severe reflux to name a few.
When pulmonary fibrosis occurs as a disease unto itself, unassociated or not caused by other diseases, the problem had always been complicated by the fact that no treatment was shown to be uniformly helpful in slowing the disease process or improving survival. Two new drugs have now been approved for the treatment of this disease. They are extremely expensive, costing in the tens of thousands of dollars a year.
Patients with pulmonary fibrosis will no doubt flock to their physician for these products in the hope of curing their disease. I wish these medications had that power. Pirfenidone and nintedanib have been shown to reduce the rate of decline in some portions of lung function but no data is available to say that they will prolong a patient’s life nor make his symptoms better. These drugs are a welcome alternative to no therapy at all, but doctors will need to be sure and explain the risks and benefits as well as the costs of these new therapies so that the benefits to our patients are not exceeded by expectations of improvement or cure.