Real-life-Persistence to Antifibrotic Treatments in the French Population
Author(s)
Vincent Cottin, MD, PhD1, Marie Najean, MD2, Elise Arnée, PharmD3, Clémentine Dillard, PhD2, XAVIER ANSOLABEHERE, MSc3, Maxime Doublet, MSc3, Julien Chollet, MSc2, Sylvie Leroy, MD4, Stéphane Jouneau, MD, PhD5.
1National coordinating reference center for rare pulmonary diseases, department of respiratory medicine, Louis Pradel hospital, UMR 754, ERN-LUNG, University Lyon 1, Lyon, France, 2Boehringer Ingelheim, Paris, France, 3Clinityx, Boulogne-Billancourt, France, 4Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, IHU RespirERA, Department of Respiratory Medicine, Centre for Rare Pulmonary Diseases, CNRS UMR 7275, Nice, France, 5Department of Respiratory Medicine, Reference Centre for Rare Pulmonary Diseases, CHU Rennes, Univ Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) – UMR_S 1085, Rennes, France.
1National coordinating reference center for rare pulmonary diseases, department of respiratory medicine, Louis Pradel hospital, UMR 754, ERN-LUNG, University Lyon 1, Lyon, France, 2Boehringer Ingelheim, Paris, France, 3Clinityx, Boulogne-Billancourt, France, 4Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, IHU RespirERA, Department of Respiratory Medicine, Centre for Rare Pulmonary Diseases, CNRS UMR 7275, Nice, France, 5Department of Respiratory Medicine, Reference Centre for Rare Pulmonary Diseases, CHU Rennes, Univ Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) – UMR_S 1085, Rennes, France.
OBJECTIVES: Antifibrotics (AF) significantly enhance patient survival, yet high treatment discontinuation rates may lead to unsatisfactory outcomes. This nationwide study aimed to assess AF treatment persistence in France, with regional stratification.
METHODS: Using the SNDS healthcare database, we identified all patients who initiated AF treatment between 2019 and 2021 in France, and calculated their persistence rate until lung transplantation, death, or end of study (December 31, 2022). Treatment discontinuation was defined as the absence of a new dispensation within 60 days after the last recorded exposure.
RESULTS: A total of 4,935 patients were included: 69.7% diagnosed with idiopathic pulmonary fibrosis, 5.0% with systemic sclerosis, and 25.3% with other diagnoses. Patients received nintedanib (n=3,351, 67.9%) or pirfenidone (n=1,584, 32.1%). At 12 months, persistence to nintedanib was 68.1% and 61.3% for pirfenidone. A persistence decrease of nearly 15% was observed between months 6 and 12, followed by a slower decline, reaching 53.1% (nintedanib) and 50.7% (pirfenidone) at month 30. Regional disparities in persistence rates were observed: persistence was notably lower in Bourgogne-Franche-Comté and Provence-Alpes-Côte d’Azur (PACA). At 12 months, persistence with nintedanib was lowest in Bourgogne-Franche-Comté (52%), whereas pirfenidone showed reduced persistence in several western and southern regions, including Centre-Val de Loire (55%), Pays de la Loire (56%), Nouvelle-Aquitaine (51%), and PACA (52%).
CONCLUSIONS: This real-life study, encompassing 99% of the French populations highlighted that one-third of AF-treated patients discontinued therapy in the first year. Persistence appeared to be influenced by regional residence, highlighting the need for strategies to improve long-term adherence across the French territory.
METHODS: Using the SNDS healthcare database, we identified all patients who initiated AF treatment between 2019 and 2021 in France, and calculated their persistence rate until lung transplantation, death, or end of study (December 31, 2022). Treatment discontinuation was defined as the absence of a new dispensation within 60 days after the last recorded exposure.
RESULTS: A total of 4,935 patients were included: 69.7% diagnosed with idiopathic pulmonary fibrosis, 5.0% with systemic sclerosis, and 25.3% with other diagnoses. Patients received nintedanib (n=3,351, 67.9%) or pirfenidone (n=1,584, 32.1%). At 12 months, persistence to nintedanib was 68.1% and 61.3% for pirfenidone. A persistence decrease of nearly 15% was observed between months 6 and 12, followed by a slower decline, reaching 53.1% (nintedanib) and 50.7% (pirfenidone) at month 30. Regional disparities in persistence rates were observed: persistence was notably lower in Bourgogne-Franche-Comté and Provence-Alpes-Côte d’Azur (PACA). At 12 months, persistence with nintedanib was lowest in Bourgogne-Franche-Comté (52%), whereas pirfenidone showed reduced persistence in several western and southern regions, including Centre-Val de Loire (55%), Pays de la Loire (56%), Nouvelle-Aquitaine (51%), and PACA (52%).
CONCLUSIONS: This real-life study, encompassing 99% of the French populations highlighted that one-third of AF-treated patients discontinued therapy in the first year. Persistence appeared to be influenced by regional residence, highlighting the need for strategies to improve long-term adherence across the French territory.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH204
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)