Journal Club - Nintedanib in Progressive Fibrosing ILDs

Location: 

Calgary, Alberta

Date: 

Oct 31, 2019

Reference: Nintedanib in Progressive Fibrosing Interstitial Lung Diseases
The New England Journal of Medicine
Dr. Brown at the Department of Medicine, National Jewish Health.
Published Sept 29, 2019 at NEJM.org
DOI: 10.1056/NEJMoa1908681

Lead by:  Dr. Tourin
Duration: 30 minutes
Discssion: Preclinical data have suggested that nintedinab, an intracellular inhibitor of tyrosine kinases, inhibits processes involved in the progression of lung fibrosis. Although the efficacy of ninedinab has shown in idiopathic pulmonary fibrosis, its efficacy across a broad range of fibrosing lung diseases is unknown.  

A total of 663 patients were treated. In the overall population, the adjusted rate of decline in FVC was – 80.8 ml per year with nintedanib and 187.8 ml per year with placebo, for a between-group difference  of 107.0 ml per year (95% confidence interval [CI], 65.4 to 148.5 P<0.001). In patients with UIP-like fibrotic pattern, the adjusted rate of decline in the FVC was 82.9 ml per year with nintedinab and – 211.1 ml per year with placebo, for a difference of 128.2 ml (95% CI, 708.8 to 185.6 P<0.001). Diarrhea was the most common adverse event, as reported in 66.9% and 23.9% of patients treated with nintedinab and placebo, respectively. Abnormalities on liver-function testing were more common in nintedinab group than in the placebo group.  

Conclusion:  In patients with progressive fibrosing interstitial lung diseases, the annual rate of decline in the FVC was significantly lower among patients who received nintedanib than among those who received placebo. Diarrhea was a common adverse event.