Systematic-Review-Drug-Efficiency-Dissertation-Sample-Work-Tutors-India

tolerability and safety of pirfenidone and acetylcysteine combination therapy in IPF. The
research considered several researches wherein the research by Sakamoto et al 73 was also
taken into account by Behr et al 74 . It is revealed that in European nations, according to 75 and
76
, more than one third of patients were reported to have received both acetylcysteine and
pirfenidone. After the PANTHER study 77 , there is a decline in the use of acetylcysteine;
however, only two researches by Sakamoto et al 78 and Oltmanns et al 79 have examined the
combined efficacy of pirfenidone and acetylcysteine. In this context, Behr et al 80 conducted a
PANORAMA study to investigate the tolerability and safety of oral acetylcysteine with
pirfenidone for the treatment of IPF.
The examination of all the studies revealed contrasting information regarding the efficacy of
the combined drug therapy. Though it is revealed that several clinical trials have been
conducted for treating IPF, the disease still remains to be a fatal and a progressive disease 81 82 .
However, with the aim to provide a novel combination that could effectively treat IPF, the
study by Sakamoto et al 83 examined the combination therapy of pirfenidone and inhaled NAC
which revealed that the treatment improved the values of FVC in more than 45 per cent of
patients with advanced IPF. It is further revealed that in the intervention group receiving
combined treatment, the value of PFS was better than those in the control group receiving
Pirfenidone alone. The results of the research further reveal the fact that in patients with
advanced IPF, inhaled NAC and pirfenidone decreased the risks of poor outcomes. However,
73
https://www.ncbi.nlm.nih.gov/pubmed/25639750
74 https://www.ncbi.nlm.nih.gov/pubmed/27161257
75 Behr J, Kreuter M, Hoeper MM, et al. Management of patients with idiopathic pulmonary fi brosis in clinical
practice: the INSIGHTS-IPF registry. Eur Respir J 2015; 46: 186–96
76
Oltmanns U, Kahn N, Palmowski K, et al. Pirfenidone in idiopathic pulmonary fi brosis: real-life experience
from a German tertiary referral center for interstitial lung diseases. Respiration 2014; 88: 199–207
77
Martinez FJ, de Andrade JA, Anstrom KJ, King Jr TE, Raghu G, for the Idiopathic Pulmonary Fibrosis
Clinical Research Network. Randomized trial of acetylcysteine in idiopathic pulmonary fi brosis. N Engl J Med
2014; 370: 2093–101.
78
https://www.ncbi.nlm.nih.gov/pubmed/25639750
79
Oltmanns U, Kahn N, Palmowski K, et al. Pirfenidone in idiopathic pulmonary fi brosis: real-life experience
from a German tertiary referral center for interstitial lung diseases. Respiration 2014; 88: 199–207
80
https://www.ncbi.nlm.nih.gov/pubmed/27161257
81 King TE Jr, Albera C, Bradford WZ, Costabel U, Hormel P, Lancaster L, Noble PW, Sahn SA, Szwarcberg J,
Thomeer M et al. INSPIRE Study Group. Effect of interferon gamma-1b on survival in patients with idiopathic
pulmonary fibrosis (INSPIRE): a multicentre, randomised, placebo-controlled trial. Lancet 2009; 374: 222–8.
82
King TE Jr, Behr J, Brown KK, du Bois RM, Lancaster L, de Andrade JA, Stähler G, Leconte I, Roux S,
Raghu G. BUILD-1: a randomized placebo-controlled trial of bosentan in idiopathic pulmonary fibrosis. Am.
J.Respir.Crit.Care Med. 2008; 177: 75–81.
83 https://www.ncbi.nlm.nih.gov/pubmed/25639750
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