Idiopathic pulmonary fibrosis(IPF) is a chronic progressive fibrotic interstitial pneumonia of unknown etiology. In some randomized trials, pirfenidone is an antifibrotic agent that has been shown to delay the progression of IPF. However, it isn9t easy to continue the full dose of pirfenidone used in clinical trials. Our study aimed to evaluate the efficacy of low-dose pirfenidone for patients with IPF. We retrospectively reviewed patients9 medical records with IPF at a single center from 2011 to 2021. Patients were divided into three groups: those not treated with pirfenidone(control) and those treated with pirfenidone at doses less than 1200 mg/day(low dose group) and more than 1200 mg/day(high dose group). Clinical features and pulmonary function were compared between the three groups. Of 118 patients, 64(54.2%) received pirfenidone and 54(45.8%) did not receive antifibrotic agents. Of the 64 patients treated with pirfenidone, 48(75.0%) and 16 (25.0%) received 773.79 and 1509.97 mg pirfenidone per day, respectively. Changes in forced vital capacity(FVC) for six months were -180, 80, and -10 mL in the control, low-dose, and high-dose groups(p<0.001). Changes in FVC over 12 months were -270, 30, and -250 mL in the control, low-dose, and high-dose groups(p=0.001). FVC was significantly decreased in the control group than in the low-dose and high-dose groups. There was no significant difference in FVC change between the low-dose and high-dose groups. Continuing administration of pirfenidone at low doses would effectively reduce disease progression of IPF in real-world practice.
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