If you have scarring in your lungs, you may have been diagnosed with pulmonary fibrosis. When the reason for this scarring is unknown, your condition is calledidiopathic pulmonary fibrosis. You likely know what a scar looks like on your skin. When your lungs have scarring, they have trouble working to move air in and out of your body. You may have sought help because you get short of breath easily, or your lung scarring may have been found during a test like an X-ray.
When your lungs do not work well, you may have a decline in lung function. Health care providers may use pulmonary function tests to see how well you can move air in and out of your lungs. One measure is called forced vital capacity (FVC). As the name suggests, FVC is the amount of air you can forcefully breathe out after taking a deep breath.
Pulmonary fibrosis is a progressive problem. This means that your lung scarring will get worse over time. On a brighter note, the first new medicine for this problem in over 10 years is now available. The name of this medicine is Jascayd (nerandomilast), and it is pronounced as JASS-Kayd. Use of Jascayd may help slow the advance of IPF. We will now take a look at how well this medicine works to slow the loss of lung function.
How Was Jascayd Studied for People With IPF, and What Were the Results?
People with IPF lose lung function over time. Jascayd was studied in a small group of people for over 12 weeks. The results were good, so a larger study was done to see if Jascayd could slow the loss of lung function over a year.
People were assigned to get Jascayd 18 mg twice daily, Jascayd 9 mg twice daily, or placebo (no medicine) twice daily. They were divided up so that each group included the same number of people taking either Jascayd alone or Jascayd with another medicine for IPF (nintedanib or pirfenidone). Both nintedanib and pirfenidone are medicines used to treat IPF, and most people were taking one of these medicines. The percentages of people in each group taking Jascayd alone or with another medicine for IPF are shown in the table below.
Jascayd 18 mg Twice Daily | Jascayd 9 mg Twice Daily | Placebo | |
| Jascayd | 22.2% | 22.4% | 22.1% |
| Jascayd with nintedanib | 45.4% | 46.9% | 44.0% |
| Jascayd with pirfenidone | 32.4% | 30.6% | 33.8% |
People in the study were 70 years old on average and mainly male (83%). By race, 68% were White, 32% were Asian, and less than 1% were Black or African American. On average, people were able to forcefully blow out about 78% of the predicted amount of air from their lungs after taking a deep breath. Thus, at the start of the study, the average FVC was 78% of what was predicted. About 1 in 5 people needed to use oxygen.
Over a year, people who took Jascayd at either 9 mg or 18 mg twice a day lost less lung function than people who took a placebo. Although FVC dropped for all groups, the average decline in FVC from the start of the study was less among people who took either dose of Jascayd. The table below shows the average changes in FVC (in milliliters, or mL) from the beginning to the end of the study.
Jascayd 18 mg Twice Daily | Jascayd 9 mg Twice Daily | Placebo | |
| Average change in FVC | -114.7 mL | -138.6 mL | -183.5 mL |
How Can I Manage Side Effects?
Diarrhea can be caused by many things, including medicines. Jascayd may give you diarrhea. In the year-long study of people taking Jascayd alone for IPF, 26% of people taking 18 mg twice daily had diarrhea. Among those taking 9 mg twice daily, 17% had diarrhea. Fewer people (8%) who took a placebo (no medicine) had diarrhea.
Your risk of diarrhea may be higher if you use another medicine for IPF. For example, most people (about 78%) in the year-long study took another medicine for IPF. Among all participants, diarrhea occurred in 42% of those taking Jascayd 18 mg twice daily, 31% of those taking Jascayd 9 mg twice daily, and 17% of those taking a placebo.
Your risk may also be higher when you first start taking Jascayd. In the year-long study, most people had diarrhea that was not too bad. However, some people had to stop Jascayd because of diarrhea.
You can do many things to help yourself if you get diarrhea. Make sure that you do not lose too much water and become dehydrated. Try to drink small amounts of water throughout the day. You may want to use an electrolyte replacement product, especially if you have diarrhea that lasts more than one or two days or is really bad. If you notice that you are not urinating (peeing) as much, your pee is dark yellow, or you have a headache, you need to get rehydrated quickly.
In addition to helping replace water and electrolytes, you want to avoid both caffeine and alcohol. These can cause your body to lose water. Carefully read the labels of all prepackaged drinks to make sure that they do not contain alcohol or caffeine.
If you get diarrhea, try to eat bland foods such as rice or toast. Stay away from fatty, spicy, or greasy foods. Consider writing down how many times a day you have diarrhea and when it started.
If your diarrhea is bothering you, severe, or lasts more than a few days, call your health care provider. They may need to check you to figure out why you have diarrhea. If Jascayd is the reason, they may tell you to lower the dose or stop taking the medicine. Do not lower the dose or stop the medicine on your own. Closely follow your health care provider’s instructions.
What Kinds of Drug Interactions May Happen?
Before you start Jascayd, tell all of your health care providers about all the medicines you take. Other medicines may affect how much Jascayd you need.
Many people may only consider drug interactions when they start a new medicine. However, stopping a medicine can also sometimes cause a problem.
If you start a new medicine or stop one after you begin taking Jascayd, talk with your health care provider. Some medicines can increase the amount of Jascayd in your body. If you stop one of these medicines, you may need a higher dose of Jascayd.
What Support Is Available for Me?
Living with a progressive disease can be scary. The drugmaker of Jascayd has a free support program in the form of a care team. The care team does not provide medical advice but can help you understand your condition and treatment. To learn more, you can call 844-527-2293 or visit their website.
