Pamufetinib (TAS-115) for Chronic Fibrosing Interstitial Lung Diseases with a Progressive Phenotype: A double-blind, multicenter, phase 2b Clinical Trial.
No recommended therapy exists for chronic fibrosing interstitial lung diseases (CF-ILD) with disease progression despite ongoing treatment with nintedanib or pirfenidone. Pamufetinib (also known as TAS-115) is a novel oral antifibrotic tyrosine kinase inhibitor in development for CF-ILD with a progressive phenotype.
We sought to evaluate the dose-response of pamufetinib monotherapy in patients with CF-ILD including idiopathic pulmonary fibrosis (IPF) with a progressive phenotype despite an antifibrotic treatment.
In this double-blind, multicenter, active-controlled phase 2 b study, patients with CF-ILD with a progressive phenotype (defined as ≥ 5% decline in the annual percent predicted forced vital capacity [%FVC] despite treatment with nintedanib or pirfenidone and an %FVC ≥ 50%) were randomized 1:1:1 to pamufetinib 50 mg, 100 mg, or control (nintedanib or pirfenidone) for ≥ 26 weeks. The primary endpoint was the 26-week rate of decline in FVC.
Of the 243 patients randomized, approximately 70% had IPF. The 26-week rate of change in FVC was -157.8 mL, -95.9 mL, and -63.6 mL in patients receiving pamufetinib 100 mg, pamufetinib 50 mg, and control, respectively; as such, no clear dose-response relationship was observed. The most frequent adverse event in the pamufetinib groups was rash, which was mostly mild or moderate in severity.
While the safety profile was acceptable, pamufetinib failed to decelerate FVC decline in patients with CF-ILD with a progressive phenotype who had previously been treated with nintedanib or pirfenidone. No benefits were demonstrated by switching from standard antifibrotic treatment to pamufetinib monotherapy.Clinical trial registered with the Japan Registry of Clinical Trials (https://jrct.mhlw.go.jp/en-top; jRCT2051210050).
We sought to evaluate the dose-response of pamufetinib monotherapy in patients with CF-ILD including idiopathic pulmonary fibrosis (IPF) with a progressive phenotype despite an antifibrotic treatment.
In this double-blind, multicenter, active-controlled phase 2 b study, patients with CF-ILD with a progressive phenotype (defined as ≥ 5% decline in the annual percent predicted forced vital capacity [%FVC] despite treatment with nintedanib or pirfenidone and an %FVC ≥ 50%) were randomized 1:1:1 to pamufetinib 50 mg, 100 mg, or control (nintedanib or pirfenidone) for ≥ 26 weeks. The primary endpoint was the 26-week rate of decline in FVC.
Of the 243 patients randomized, approximately 70% had IPF. The 26-week rate of change in FVC was -157.8 mL, -95.9 mL, and -63.6 mL in patients receiving pamufetinib 100 mg, pamufetinib 50 mg, and control, respectively; as such, no clear dose-response relationship was observed. The most frequent adverse event in the pamufetinib groups was rash, which was mostly mild or moderate in severity.
While the safety profile was acceptable, pamufetinib failed to decelerate FVC decline in patients with CF-ILD with a progressive phenotype who had previously been treated with nintedanib or pirfenidone. No benefits were demonstrated by switching from standard antifibrotic treatment to pamufetinib monotherapy.Clinical trial registered with the Japan Registry of Clinical Trials (https://jrct.mhlw.go.jp/en-top; jRCT2051210050).
Authors
Okuda Okuda, Nishioka Nishioka, Kondoh Kondoh, Tsubouchi Tsubouchi, Okamoto Okamoto, Nishiyama Nishiyama, Sato Sato, Oishi Oishi, Ishikawa Ishikawa, Chiba Chiba, Miyazaki Miyazaki, Homma Homma, Ogura Ogura, Inoue Inoue, Azuma Azuma
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