2019 journal article
Safety and efficacy of topically applied 0.5% and 1% pirfenidone in a canine model of subconjunctival fibrosis
VETERINARY OPHTHALMOLOGY, 22(4), 502–509.
Abstract Objective To evaluate tissue levels, safety, and efficacy of topical ophthalmic 0.5% and 1% pirfenidone in decreasing subconjunctival fibrosis. Animal studied Twelve normal beagle dogs Procedures A 5 × 1 mm diameter silicone disk was implanted subconjunctivally in one eye, and then dogs were treated with topical 0.5% pirfenidone (n = 9) in artificial tears or artificial tears alone (n = 3) for 28 days. To evaluate tissue drug levels, a single sample of tears, conjunctiva, and aqueous humor was collected 30 (n = 3), 90 (n = 3), and 180 min (n = 3) following administration of the last drop of pirfenidone, respectively. Fibrous capsule thickness and staining for Ki67 and fibroblast activation protein alpha ( FAP α) were evaluated histologically. After a 2‐week washout, the experiment was repeated in the opposite eye and using 1% pirfenidone. Results Treatment with pirfenidone resulted in thinner fibrous capsules and decreased staining for FAP α with no adverse effects. The implant in one dog treated with pirfenidone extruded. There was no difference in tissue levels, capsular thickness, or staining for Ki67 or FAP α between dogs treated with 0.5% or 1% pirfenidone. Conclusions Pirfenidone may decrease fibrosis following glaucoma shunt surgery and can potentially be used indefinitely due to minimal side effects.