What influences patient choice of antifibrotic treatment in IPF

Pirfenidone and Nintedanib are both available in the UK for patients who have an ILD MDT confirmed diagnosis of IPF and have an FVC 50-80% of their predicted value. The evidence to date shows that the efficacy of the two available drugs are equivalent but mode of action, metabolism and side effects differ. If there is no medical contraindication to one of the drugs, we provide the drug information leaflets provided by Boehringer Ingelheim and Roche. At the next clinic visit 4 weeks later, we ask the patient to choose treatment (or no antifibrotic treatment). We then ask them to complete a short questionnaire asking them who influenced the decision and why they have made their choice. The results are shown in the tables 1-2. Conclusions: The main factor influencing patient choice was the importance of diarrhoea or photosensitivity. The tablet count favoured Nintedanib. The number of clinic visits and blood test influenced the choice for no treatment. The patients believed that their doctors were more influential than the doctors believed themselves.