Antifibrotic treatment in Pulmonary Fibrosis

In this video about antifibrotic treatments for pulmonary fibrosis. Two medications are available (pirfenidone and nintedanib). These drugs may be prescribed for the following indications:
1. Idiopathic Pulmonary Fibrosis - both pirfenidone and nintedanib
Video about IPF: • What is idiopathic pul...
2. Progressive Fibrosing Interstitial Lung Disease (PF-ILD) or Progressive Pulmonary Fibrosis (PPF) - nintedanib only
3. Systemic sclerosis associated interstitial lung disease (SSc-ILD) - nintedanib only
Video about SSc-ILD: • Lung disease in sclero...
These indications may change over time, and new medications may become approved. This information is valid as of April 2023. Please check with your doctor for accurate information in your case.
Antifibrotic medications do not "cure" fibrosis, but they can slow down the progression of the disease. This means that in the long run, being on the medication may be better than not having it. Lung function would be preserved for longer.
There are some potential side effects that I discuss in the video.
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Disclaimers:
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For all viewers/listeners:
The information presented here or in other videos and posts on this channel is not medical advice. These materials reflect general medical knowledge which may not apply to your individual case. If you have health concerns, please see your own doctor or other healthcare provider without delay.
For medical professionals:
You must use your professional judgement when treating your patients. The information presented in this and other videos/posts on this channel is for general medical education only. It may not apply to all patients or clinical scenarios.
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[@DrStefanCristianStanel]

I started another channel dedicated to Interstitial Lung Diseases (ILD) and lung fibrosis if you are interested: www.youtube.com/@InterstitialLungDisease

[@ireneeickenhorst2326]

Thank you, these videos have been so helpful for me. I will be 86 in 3 days I opted to not do the medication at this point in my life I look for ways to enjoy it as best as possible and did not want to deal with the side effects.

[@DrStefanCristianStanel]

Thank you for your message, this can be a perfectly reasonable choice, I wish you all the best and hope you are having good support from your healthcare team

[@naomiweida2384]

This is a great lecture. My dad was recently diagnosed with IPF by Dr. Boltax at The U (we were overly impressed with him and his team). This medication is amazing, we choose Ofev because my dad wants to stay out in the sun and stay active. It will be nice when more information comes out about the medications regarding drug to drug interaction.

[@francasimonetta3849]

Thank you so much I was recently diagnosed and I am very scared. I’m 62 years old. I have psoriatic arthritis and was on Humira and I think it was Dehm that brought it on. I could see my rheumatologist on Monday and will go from there but I’m starting to have a hard time breathing. Thank you so much for explaining everything.

[@padmeshsethuraman5617]

I’m 66 year old Indian male. In my annual check done last month, chest X Ray showed some shadow (scarring). I do not have breathing difficulties. I do not have clubbing of nails. No coughing. So my GP did not advise any further investigation. My son insisted for further checking. I consulted a pulmonologist a week later. He prescribed Chest CT scan and 3 blood tests. Based on the reports he advised no further treatment. I have psoriasis and mild psoriatic arthritis since 36 years. I’m taking a probiotic to keep my skin from flaring. AxisBiotix. I’m hoping and praying that the situation does not worsen. I’m taking 50mg of Zinc picolinate once daily as psoriasis patients loose zinc in the scales and are low in zinc. Low zinc can cause fibrosis

[@jamessang5027]

Fibrosis is caused by nutrient deficiencies , specifically vitamun a , vitamin d and zinc deficiencies

[@WJK2198]

If it were only that easy. I’m not deficient in any the vitamin you listed

[@IntendJOY]

Greatly helpful! Thank you so much

[@digitalrajkot1465]

Is getting tired a side effect of fibrosis? With medicine what is the survival rate?

[@kosalabandaranayaka8333]

Great video doctor, is there any updated treatments? My father has ipf and on perfinidone, has a lot of side effects and he is getting weaker as a result of loss of Appetite and loss of sodium

[@cookie-gb3xn]

I sometimes wonder if i should be on any medication at this time. I moved out my old house which had mold in the basement. Sincevthen my ct scans show no progression. My 6 minute walks test remain above 92 which is good because i do have scarring. When you're not breathing in mold...it really have me feeling mych better!

[@cookie-gb3xn]

I have fibrotic sarcoidosis. Scarring mainly in right upper lung. My pulmonologist put me on nintedenib. Not using oxygen.

[@Ubht856]

Sir how long a patient survive with ILD having antifibrotic drug from its early stage of diseases ?

[@lorismith5369]

Thank you!

[@aaronwalcott513]

"One day" is now. There are a few vids already out on YT that suggest autophagy of the scarred tissue (achieved by fasting) and replacement of phaged tissue with stem cells (achieved by fasting). Of course more research into the duration of the fast(s) and the diet after to prevent refeeding syndrome is needed. But it seems promising.

[@joshuagriffin9054]

What are those videos called

[@janball3356]

I have been diagnosed with ipf and wonder if reflux could have caused it. I was prescribed Omeprazole but they made me vomit and l was wary of taking them anyway, so l didn't. I use a bed wedge and sleep on my left side and occasionally take Gavescon for stomach acid. But still now have IPF. Also do inhalers help with this desease. Thank you.

[@moviestelugunow2931]

Features are consistent with Fibrosing Interstitial Pneumonia with Microscopic Honeycombing and Peripheral Fibrosis with Smooth muscle Prominence. Fibroblast Focus Activity is Low. Possibility of usual Interstitial Pneumonia is Considered Sir this is my condition may i recover from it is any cure or treatment for this my age is just 22 years only please help me to figure this out sir suggest me me the treatment and medicine sir

[@joselenetancingco4828]

use mohringa powder with honey .make it your coffee everyday.

[@ceciliamok3579]

After taking prifenidone for two weeks, my husband found breathing worse than before is this the side effect, he takes 2 capsule one time, if one capsule at a time not so bad

[@Annliyalovesyou]

Ofev dosage is one cap dupe two times a day Please consult with your Dr.

[@maxitosh8465]

What is the rational behind the FVC criteria for anti-fibrotics?

[@DrStefanCristianStanel]

Super complicated answer, generally it's a combination of study results and cost effectiveness

[@maxitosh8465]

Scary that a person could have significant fibrosis but not qualify for anti-fibrotic treatment; one has to say that the pharmaceutical companies really do have a lot to answer for - 30,000 per year per patient for anti-fibrotics….reminds me somehow of all those poor children with SMA who can’t access the meds and need to try and crowd fund. Something deeply deeply wrong with the system as is. “Somethings got to be done, we can’t go on like this”

[@TJ-Dives]

You do not mention kidney failure, liver problems with pirfenidone.

[@DrStefanCristianStanel]

these are potential problems with most medications. with antifibrotics such as pirfenidone or nintedanib we tend to monitor liver and kidney function with blood tests every 3 months and if no changes we continue treatment

[@masonryjoe]

What about serrapeptase ?

[@vishwajeetkumarsrivastava]

Wanted to consult you for fibrosis

[@eyeofps]

Try Himveda in Dharamshala

[@lisabyrd754]

​@jojins1 what country is this in?MY husband has it and I'm trying everything.

[@lisabyrd754]

​@jojins1 what country is this in?MY husband has it and I'm trying everything.

[@lisabyrd754]

​@jojins1 what country is this in?MY husband has it and I'm trying everything.

[@vishwajeetkumarsrivastava]

@@lisabyrd754 INDIA