Patient-reported adverse events and management of antifibrotic therapy in IPF: A multicenter, cross-sectional real-world study.

BackgroundAntifibrotic agents slow disease progression and improve survival in IPF, yet real-life data on their use in Turkey are limited.ObjectivesThis study aimed to compare the side effects of antifibrotics in IPF patients.DesignA cross-sectional survey was conducted in 8 centers across 6 provinces in the Aegean Region.MethodsThere were 470 IPF patients who completed a 30-item face-to-face questionnaire. Adverse events and their management were compared between pirfenidone and nintedanib users.ResultsAmong 470 patients, 50.6% used pirfenidone and 49.4% nintedanib. Overall, 70.6% reported at least one side effect (75.5% nintedanib vs. 66% pirfenidone, p=0.023). Medical treatment was required in 30.9% and dose reduction in 18.9%. The most common side effects were diarrhea (30.6%), appetite loss (24.9%), and nausea (22.3%). Diarrhea (p<0.001) and weight loss (p=0.010) were more frequent with nintedanib, while rash, photosensitivity, and fatigue were more common with pirfenidone (all p<0.001). Nausea, vomiting, appetite loss, and fatigue were more frequently reported in women, and vomiting, anorexia, and rash were more frequently observed in patients with comorbidities.ConclusionAdverse events are frequent in IPF patients receiving antifibrotics. Nintedanib mainly causes gastrointestinal symptoms, whereas pirfenidone leads to skin reactions and fatigue. Female sex and the presence of comorbidities were associated with a higher frequency of certain adverse events. Supportive treatment and dose adjustments are crucial for maintaining adherence.