COPD

[Guest]

My husb diagnosed idiopathic copd 6 years ago. He does not smoke. He is presently on oxygen rapy - setting on 2.5 or 3. He is 60 yrs old still some active. F questions: 1. A new drug called Perfenidone is in trial tests. Could new drug help or cure? 2. Could a new drug called ATRA be a treatment or cure? 3. about laser surgery? 4. is life expectency after a lung transplant? At one time it 50% one year. Thanks

[Guest]

Pirfenidone was trialed a couple years ago for Hermansky-Pudlak syndrome. Dr Ganesh Raghu (UWashington/seattle) published a paper a couple years ago following a trial with IPF patients. This drug didn't turn out to be all it was cracked up to be. The newest Interferon Gamma (1b) (Actimmune) is showing much more promise; it's also reportedly being fasttracked with the FDA. Neither of these drugs would be considered curative. ATRA, or All-Trans Retinoic Acid, is currently being trialed in 10 centers around the country for application in emphysema patients. This would have no bearing on pulmonary fibrosis. In fact, ATRA has been shown to cause fibrosis in patients being treated with it for APL. oh.. I transgress! If you do a search on the net for FORTE study, you should come up with the centers participating in ATRA trials. In Boston I believe it's New Engand Med Center. Laser surgery -- I think you're referring to lung volume reduction surgery. This procedure is only used for emphysema patients. It's unlikely it would be performed on someone who has both emphysema and pulmonary fibrosis, but that's just my opinion..

[Guest]

I have no information on perfenidone, did not even come up on the literature search I did. ATRA is a retinoic acid (vitamin A) and is not a cure. Lung reduction surgery can give significant improvement in a select group of patients. Lung transplant, without a heart lung transplant, has a one year survival of about 72% and 2 year of .60%, heart lung has a one year survival of 50%

[Guest]

Dr. Sol Margolin of Dallas is researching perfenidone. Dr. James Bowen of Seattle is also doing clinical trials.

[Guest]

"What's in the Future for Patients with IPF" at http://www.pulmonaryreviews.com/apr00/pr_apr00_IPF.html contains references to articles by Dr G. Raghu on Pirfenidone, in the event you're interested.