Nintedanib, pirfenidona y células madre como tratamiento de las enfermedades pulmonares intersticiales Fibrosantes Progresivas
DOI:
https://doi.org/10.34119/bjhrv6n1-227Keywords:
células madre, Fibrosis Pulmonar, nintedanib, pirfenidona, terapiaAbstract
Introducción: Las enfermedades pulmonares intersticiales fibrosantes progresivas las conforman un grupo de patologías que se producen cuando la fibrosis avanza a pesar de las medidas terapéuticas. El tratamiento de estas patologías continúa en investigación, pues en los últimos años se han desarrollado fármacos antifibróticos que prometen mejorar la calidad de vida del paciente y retardar la progresión de la enfermedad, a esto se suman los nuevos estudios de trasplante de células madre que no solo evidencian un perfil de seguridad aceptable y bien tolerado, sino efectos adversos manejables. Objetivo: Describir al Nintedanib, Pirfenidona y células madre como tratamiento de las enfermedades pulmonares intersticiales fibrosantes progresivas. Metodología: Se realizó una revisión sistemática usando el método PRISMA. Resultados: Se obtuvieron 473 artículos recuperados de las bases de datos de Pubmed y Scopus, de los cuales se seleccionaron 16 de acuerdo con los criterios de elegibilidad. Conclusiones: Los hallazgos de esta investigación fueron que Nintedanib y Pirfenidona ralentizan la disminución de la Capacidad Vital Forzada, el riesgo de mortalidad es mayor en pacientes con fibrosis idiopática que en otro tipo de fibrosis, los efectos adversos más comunes asociados a Nintedanib son la diarrea, nausea, vómito y cefalea, mientras que con Pirfenidona son los trastornos gastrointestinales, fatiga, erupciones cutáneas, mareo, fotosensibilidad y pérdida de peso. La terapia con células madre demuestra seguridad y efectos adversos tolerables y manejables; aunque, se necesitan más estudios.
References
Ali, K. M., Rahim Fattah, F. H., Omar, S. H., Gubari, M. I. M., Yousefifard, M., & Hosseini, M. (2020). Mesenchymal Stromal Cells Derived Conditioned Medium in Pulmonary Fibrosis: A Systematic Review and Meta-analysis. Archives of Iranian Medicine, 23(12), 870–879. https://doi.org/10.34172/AIM.2020.116
Averyanov, A., Koroleva, I., Konoplyannikov, M., Revkova, V., Lesnyak, V., Kalsin, V., Danilevskaya, O., Nikitin, A., Sotnikova, A., Kotova, S., & Baklaushev, V. (2020). First-in-human high-cumulative-dose stem cell therapy in idiopathic pulmonary fibrosis with rapid lung function decline. Stem Cells Translational Medicine, 9(1), 6–16. https://doi.org/10.1002/SCTM.19-0037
Bahudhanapati, H., & Kass, D. J. (2017). Unwinding the collagen fibrils: Elucidating the mechanism of pirfenidone and nintedanib in pulmonary fibrosis. American Journal of Respiratory Cell and Molecular Biology, 57(1), 10–11. https://doi.org/10.1165/RCMB.2017-0079ED/SUPPL_FILE/DISCLOSURES.PDF
Behr, J., Prasse, A., Kreuter, M., Johow, J., Rabe, K. F., Bonella, F., Bonnet, R., Grohe, C., Held, M., Wilkens, H., Hammerl, P., Koschel, D., Blaas, S., Wirtz, H., Ficker, J. H., Neumeister, W., Schönfeld, N., Claussen, M., Kneidinger, N., … Froehling, K. P. (2021). Pirfenidone in patients with progressive fibrotic interstitial lung diseases other than idiopathic pulmonary fibrosis (RELIEF): a double-blind, randomised, placebo-controlled, phase 2b trial. The Lancet Respiratory Medicine, 9(5), 476–486. https://doi.org/10.1016/S2213-2600(20)30554-3
Copeland, C. R., & Lancaster, L. H. (2021). Management of Progressive Fibrosing Interstitial Lung Diseases (PF-ILD). Frontiers in Medicine, 8, 743977. https://doi.org/10.3389/FMED.2021.743977
Cottin, V., Richeldi, L., Rosas, I., Otaola, M., Song, J. W., Tomassetti, S., Wijsenbeek, M., Schmitz, M., Coeck, C., Stowasser, S., Schlenker-Herceg, R., & Kolb, M. (2021). Nintedanib and immunomodulatory therapies in progressive fibrosing interstitial lung diseases. Respiratory Research, 22(1). https://doi.org/10.1186/S12931-021-01668-1
Crestani, B., Huggins, J. T., Kaye, M., Costabel, U., Glaspole, I., Ogura, T., Song, J. W., Stansen, W., Quaresma, M., Stowasser, S., & Kreuter, M. (2019). Long-term safety and tolerability of nintedanib in patients with idiopathic pulmonary fibrosis: results from the open-label extension study, INPULSIS-ON. The Lancet Respiratory Medicine, 7(1), 60–68. https://doi.org/10.1016/S2213-2600(18)30339-4
Díaz Chantar, F., Juan, J. M., Gómez Izquierdo, L., Navarro Herrero, S., Serrano Gotarredona, M. P., Rodríguez Portal, J. A., & Díaz Chantar, F. (2017). ORIGINALES ANTI-FIBROTIC TREATMENT IN IDIOPATHIC PULMONARY FIBRROSIS; OUR REAL-LIFE EXPERIENCE. Sumario Rev Esp Patol Torac, 29(2), 102–106.
Distler, O., Highland, K. B., Gahlemann, M., Azuma, A., Fischer, A., Mayes, M. D., Raghu, G., Sauter, W., Girard, M., Alves, M., Clerisme-Beaty, E., Stowasser, S., Tetzlaff, K., Kuwana, M., & Maher, T. M. (2019). Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease. The New England Journal of Medicine, 380(26), 2518–2528. https://doi.org/10.1056/NEJMOA1903076
Finnerty, J. P., Ponnuswamy, A., Dutta, P., Abdelaziz, A., & Kamil, H. (2021). Efficacy of antifibrotic drugs, nintedanib and pirfenidone, in treatment of progressive pulmonary fibrosis in both idiopathic pulmonary fibrosis (IPF) and non-IPF: a systematic review and meta-analysis. BMC Pulmonary Medicine, 21(1), 1–11. https://doi.org/10.1186/S12890-021-01783-1/FIGURES/6
Flaherty, K. R., Wells, A. U., Cottin, V., Devaraj, A., Walsh, S. L. F., Inoue, Y., Richeldi, L., Kolb, M., Tetzlaff, K., Stowasser, S., Coeck, C., Clerisme-Beaty, E., Rosenstock, B., Quaresma, M., Haeufel, T., Goeldner, R.-G., Schlenker-Herceg, R., & Brown, K. K. (2019). Nintedanib in Progressive Fibrosing Interstitial Lung Diseases. New England Journal of Medicine, 381(18), 1718–1727. https://doi.org/10.1056/NEJMOA1908681/SUPPL_FILE/NEJMOA1908681_DATA-SHARING.PDF
Fleetwood, K., McCool, R., Glanville, J., Edwards, S. C., Gsteiger, S., Daigl, M., & Fisher, M. (2017). Systematic Review and Network Meta-analysis of Idiopathic Pulmonary Fibrosis Treatments. Journal of Managed Care & Specialty Pharmacy, 23(3b), S5–S16. https://doi.org/10.18553/JMCP.2017.23.3-B.S5/ASSET/IMAGES/SMALL/FIG3.GIF
FLORENZANO V, M., REYES C, F., FLORENZANO V, M., & REYES C, F. (2019). Tratamiento farmacológico en la fibrosis pulmonar idiopática. Drogas modificadoras de enfermedad. Revista Chilena de Enfermedades Respiratorias, 35(4), 287–292. https://doi.org/10.4067/S0717-73482019000400287
Galli, J. A., Pandya, A., Vega-Olivo, M., Dass, C., Zhao, H., & Criner, G. J. (2017). Pirfenidone and nintedanib for pulmonary fibrosis in clinical practice: Tolerability and adverse drug reactions. Respirology, 22(6), 1171–1178. https://doi.org/10.1111/RESP.13024
Glassberg, M. K., Minkiewicz, J., Toonkel, R. L., Simonet, E. S., Rubio, G. A., DiFede, D., Shafazand, S., Khan, A., Pujol, M. V., LaRussa, V. F., Lancaster, L. H., Rosen, G. D., Fishman, J., Mageto, Y. N., Mendizabal, A., & Hare, J. M. (2017). Allogeneic Human Mesenchymal Stem Cells in Patients With Idiopathic Pulmonary Fibrosis via Intravenous Delivery (AETHER): A Phase I Safety Clinical Trial. Chest, 151(5), 971–981. https://doi.org/10.1016/J.CHEST.2016.10.061
Heukels, P., Moor, C. C., von der Thüsen, J. H., Wijsenbeek, M. S., & Kool, M. (2019). Inflammation and immunity in IPF pathogenesis and treatment. Respiratory Medicine, 147, 79–91. https://doi.org/10.1016/J.RMED.2018.12.015
Kolb, M., & Vašáková, M. (2019). The natural history of progressive fibrosing interstitial lung diseases. Respiratory Research, 20(1), 1–8. https://doi.org/10.1186/S12931-019-1022-1/FIGURES/1
Kreuter, M., Maher, T. M., Corte, T. J., Molina-Molina, M., Axmann, J., Gilberg, F., Kirchgaessler, K. U., & Cottin, V. (2022). Pirfenidone in Unclassifiable Interstitial Lung Disease: A Subgroup Analysis by Concomitant Mycophenolate Mofetil and/or Previous Corticosteroid Use. Advances in Therapy, 39(2), 1081. https://doi.org/10.1007/S12325-021-02009-W
Krishna, R., Chapman, K., & Ullah, S. (2022). Idiopathic Pulmonary Fibrosis. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK448162/
Molina-Molina, M., Buendia-Roldan, I., Castillo, D., Caro, F., Valenzuela, C., & Selman, M. (2022). Novedades diagnósticas y terapéuticas en fibrosis pulmonar progresiva. Archivos de Bronconeumología, 58(5), 418–424. https://doi.org/10.1016/J.ARBRES.2021.12.006
Noth, I., Adegunsoye, D., & Kulkarni, T. (2020). Progressive Fibrosing Interstitial Lung Disease Primer. American Thoracic Society. https://www.thoracic.org/education-center/ild/pdf/2020_ats_pf-ild_v13_web.pdf
Olson, A., Hartmann, N., Patnaik, P., Wallace, L., Schlenker-Herceg, R., Nasser, M., Richeldi, L., Hoffmann-Vold, A. M., & Cottin, V. (2021). Estimation of the Prevalence of Progressive Fibrosing Interstitial Lung Diseases: Systematic Literature Review and Data from a Physician Survey. Advances in Therapy, 38(2), 854–867. https://doi.org/10.1007/S12325-020-01578-6
Olson, A. L., Gifford, A. H., Inase, N., Fernández Pérez, E. R., & Suda, T. (2018). The epidemiology of idiopathic pulmonary fibrosis and interstitial lung diseases at risk of a progressive-fibrosing phenotype. European Respiratory Review, 27(150). https://doi.org/10.1183/16000617.0077-2018
Petnak, T., Lertjitbanjong, P., Thongprayoon, C., & Moua, T. (2021). Impact of Antifibrotic Therapy on Mortality and Acute Exacerbation in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis. Chest, 160(5), 1751–1763. https://doi.org/10.1016/j.chest.2021.06.049
Richeldi, L., Kolb, M., Jouneau, S., Wuyts, W. A., Schinzel, B., Stowasser, S., Quaresma, M., & Raghu, G. (2020). Efficacy and safety of nintedanib in patients with advanced idiopathic pulmonary fibrosis. BMC Pulmonary Medicine, 20(1), 1–8. https://doi.org/10.1186/S12890-019-1030-4/TABLES/3
Richeldi, L., Kreuter, M., Selman, M., Crestani, B., Kirsten, A. M., Wuyts, W. A., Xu, Z., Bernois, K., Stowasser, S., Quaresma, M., & Costabel, U. (2018). Long-term treatment of patients with idiopathic pulmonary fibrosis with nintedanib: results from the TOMORROW trial and its open-label extension. Thorax, 73(6), 581. https://doi.org/10.1136/THORAXJNL-2016-209701
Shi, H., Yin, D., Bonella, F., Kreuter, M., Oltmanns, U., Li, X., Peng, S., & Wei, L. (2020). Efficacy, safety, and tolerability of combined pirfenidone and N-acetylcysteine therapy: A systematic review and meta-analysis. BMC Pulmonary Medicine, 20(1), 1–9. https://doi.org/10.1186/S12890-020-1121-2/TABLES/2
Spagnolo, P., Distler, O., Ryerson, C. J., Tzouvelekis, A., Lee, J. S., Bonella, F., Bouros, D., Hoffmann-Vold, A. M., Crestani, B., & Matteson, E. L. (2021). Mechanisms of progressive fibrosis in connective tissue disease (CTD)-associated interstitial lung diseases (ILDs). Annals of the Rheumatic Diseases, 80(2), 143–150. https://doi.org/10.1136/ANNRHEUMDIS-2020-217230
Tzouvelekis, A., Toonkel, R., Karampitsakos, T., Medapalli, K., Ninou, I., Aidinis, V., Bouros, D., & Glassberg, M. K. (2018). Mesenchymal stem cells for the treatment of idiopathic pulmonary fibrosis. Frontiers in Medicine, 5(MAY), 142. https://doi.org/10.3389/FMED.2018.00142/BIBTEX
Vancheri, C., Kreuter, M., Richeldi, L., Ryerson, C. J., Valeyre, D., Grutters, J. C., Wiebe, S., Stansen, W., Quaresma, M., Stowasser, S., & Wuyts, W. A. (2018). Nintedanib with add-on pirfenidone in idiopathic pulmonary fibrosis: Results of the INJOURNEY trial. American Journal of Respiratory and Critical Care Medicine, 197(3), 356–363. https://doi.org/10.1164/RCCM.201706-1301OC/SUPPL_FILE/DISCLOSURES.PDF
Wells, A. U., Flaherty, K. R., Brown, K. K., Inoue, Y., Devaraj, A., Richeldi, L., Moua, T., Crestani, B., Wuyts, W. A., Stowasser, S., Quaresma, M., Goeldner, R. G., Schlenker-Herceg, R., Kolb, M., Abe, S., Aburto, M., Acosta, O., Andrews, C., Antin-Ozerkis, D., … Ziora, D. (2020). Nintedanib in patients with progressive fibrosing interstitial lung diseases—subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial. The Lancet Respiratory Medicine, 8(5), 453–460. https://doi.org/10.1016/S2213-2600(20)30036-9
Wu, W., Qiu, L., Wu, J., Liu, X., & Zhang, G. (2021). Efficacy and safety of pirfenidone in the treatment of idiopathic pulmonary fibrosis patients: a systematic review and meta-analysis of randomised controlled trials. BMJ Open, 11(12), e050004. https://doi.org/10.1136/BMJOPEN-2021-050004
Xaubet, A., Ancochea, J., & Molina-Molina, M. (2017). Fibrosis pulmonar idiopática. Medicina Clínica, 148(4), 170–175. https://doi.org/10.1016/J.MEDCLI.2016.11.004
