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ILD AI 04:19 AM

Antifibrotic Therapy

October 2025

In this session, Corinne Young reviews the evolution of antifibrotic therapies for interstitial lung disease, beginning with the 2015 U.S. approval of pirfenidone (Esbriet) for idiopathic pulmonary fibrosis (IPF). Pirfenidone works by targeting TGF-β and TNF-α to slow fibroblast proliferation and collagen synthesis, though patients often experience gastrointestinal side effects and fatigue. The discussion also covers nintedanib (Ofev), a tyrosine kinase inhibitor that blocks multiple growth factor pathways (VEGF, FGF, PDGF) and is now approved for both IPF and other progressive fibrotic lung diseases. Clinical trials such as CAPACITY, ASCEND, INPULSIS, and INBUILD demonstrated that these antifibrotics significantly slow the rate of lung function decline and disease progression. The talk concludes by emphasizing careful side-effect management, liver monitoring, and appropriate patient selection to optimize outcomes with these cornerstone antifibrotic therapies.

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