ArticleNaunyn-Schmiedeberg's archives of pharmacology2026
Gastrointestinal and skin safety evaluation of pirfenidone versus nintedanib: an analysis of real-world pharmacovigilance and randomized controlled trials.
Article in Naunyn-Schmiedeberg's archives of pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
Funding
Abstract
This study compares their safety profiles using real-world pharmacovigilance data and meta-analysis to guide clinical use. The gastrointestinal disorders and skin-related ADRs listed in the latest instructions for pirfenidone and nintedanib were systematically reviewed and subsequently analyzed using the FDA Adverse Event Reporting System (FAERS) database. Adverse drug event (ADE) reports for pirfenidone (2014-Q1 2025) and nintedanib (2014-Q1 2025) were extracted from the FAERS database via OpenVigil 2.1. ADE signals were analyzed using MedDRA's system organ class (SOC) and preferred terms (PT), with reporting odds ratio (ROR) for signal detection. Randomized controlled trials (RCTs) were retrieved from Cochrane, PubMed, Embase, and ClinicalTrials.gov, and meta-analysis was performed using RevMan 5.3. Pirfenidone and nintedanib were associated with 26,352 and 9,809 ADE reports, respectively, primarily in patients aged ≥ 65. Gastrointestinal disorders were common for both, but nintedanib showed fewer skin-related ADRs. Gender-based differences were observed: nintedanib's gastrointestinal ADRs varied by gender, while pirfenidone's skin-related ADRs differed significantly. Most reports originated from the U.S. Meta-analysis of 10 RCTs (6 pirfenidone, 4 nintedanib) showed both drugs slowed forced vital capacity (FVC) decline and reduced respiratory-related mortality. Nintedanib demonstrated superior efficacy in reducing acute exacerbations (RR = 0.57, 95%CI [0.34-0.98], I2 = 47%). Both drugs primarily caused gastrointestinal ADRs (e.g., nausea, vomiting), with pirfenidone linked to more photosensitivity reactions. Integrated pharmacovigilance and RCT analyses highlight the safety profiles of pirfenidone and nintedanib, offering evidence for clinical decision-making in idiopathic pulmonary fibrosis (IPF) treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.