Living Well with a Bad Diagnosis - Lung Disease

Saturday, December 5, 2015

Choose a Drug

Christien is on the plane! It is going to be a fun few day!

Yesterday, mom and I checked out one of the new apartment complexes she was considering and it was liked an armed camp. Awful. We ran her blood pressure cuff and computer back down to the university hospital, had lunch then headed home.

Someone just asked me if I were to choose between the two new anti-fibrotic drugs, which one would I choose to take? Years ago, I was on Cellcept, with pathways through the bone marrow. Medicare refused to pay for it as it was off-label for HP so we changed to Imuran, a drug invented in the 50s by a woman biologist with pathways through the liver. My numbers were much better with the Imuran than I was getting with the Cellcept and I didn't have to have weekly blood tests.

The two new anti-fibrotic drugs: Pirfenidone and Nintedanib. The first is a brand spankin' new drug and the other is an old chemotherapy drug. The pathways with Nintedanib are clear. The doctors understand how it works. The Pirfenidone has totally different pathways, had proven that it greatly slows down the expected loss of lung capacity of patients with IPF but they really don't understand specifically why it works.

You can see where we're going here.

If I had to choose, I would start with a conversation with Dr. K. I would ask her opinion about which drug would be best for my specific disease and my level of illness. I would probably listen to her, even if I didn't agree initially, I would give her recommendation a shot. My gut tells me that if she gave me the choice, I would choose the Nintedanib.

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