Significant unmet needs remain in idiopathic pulmonary fibrosis despite recent advancements

Despite recent advances in idiopathic pulmonary fibrosis (IPF), significant unmet needs remain including increased earlier diagnosis, improved drug safety and efficacy, improvement in patient quality of life and treatments for patients with severe disease, according to GlobalData, a leading data and analytics company.

Tiffany Chan, Immunology Analyst at GlobalData, explains: “There are a number of challenges for IPF patients over the course of seeking treatment. It is difficult to make a definitive diagnosis of IPF early in the clinical course of the disease. Once diagnosed, the decline in lung function is also heterogeneous and treatment decisions have to be made on a case by case basis. Finally, key opinion leaders (KOLs) interviewed by GlobalData have noted that clinicians have to balance preserving lung function with preserving patients’ quality of life.”

Due to the idiopathic nature of the condition, a diagnosis is usually made by ruling out differential diagnoses, often taking several months to correctly diagnose the condition. IPF diagnosis requires a careful evaluation of clinical, laboratory, radiological and/or pathological data in addition to the exclusion of other disease causes, and is managed by a multi-disciplinary team working in concert. There are currently only two available therapies for the indication of IPF: Ofev (nintedanib) and Esbriet (pirfenidone). Both of these agents are oral anti-fibrotics that slow the progression of the disease, but do not improve its ultimately fatal prognosis.

Chan continues: “KOLs also noted that a fairly high proportion of patients stop using these drugs due to their side effects. Gastrointestinal side effects are common with both drugs, which raises concerns regarding tolerability and compliance. While Esbriet and Ofev do slow the progression of IPF in patients, they do not directly improve patients’ quality of life. Some patients will view their quality of life as the deciding factor regarding whether or not to undergo drug therapy, putting the current treatment options of Esbriet and Ofev at a disadvantage.”

GlobalData expects that the situation will continue to improve over the next decade, as new therapies are launched on the market and longer-term clinical trials can be conducted on more diverse patient populations. The need for diagnostics—specifically, predictive biomarkers and serum tests—to guide treatment plans is expected to remain partially unmet during the next 10 years.

Chan adds: “The demand to also find diagnostic biomarkers leaves an opportunity for increased collaboration between pharmaceutical companies and academia. However, the earlier diagnosis and treatment of all IPF patients is expected to remain elusive over the next 10 years.”

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