Nintedanib Treatment of Patients With Interstitial Lung Diseases: A Retrospective Study of Daily Clinical Practice

Abstract

Background/Aim: Nintedanib, an antifibrotic drug, is expected to slow the progression of interstitial lung diseases (ILDs). This study aimed to evaluate the usefulness of nintedanib for patients with idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) who would otherwise be excluded due to being unable to undergo invasive tests. Patients and Methods: We retrospectively reviewed the medical records of all IPF and PPF patients who received nintedanib at our hospitals. This study included 187 patients whose severity could be assessed using the Japanese Respiratory Society classification, which allows for non-invasive severity evaluation, rather than the Gender-Age-Physiology score. Patients were classified into three groups based on their nintedanib administration status: a continuation group, a dose reduction group, and a discontinuation group. Results: There were no significant differences in patient characteristics among the three groups. The duration of nintedanib administration in the discontinuation group was shorter than in the continuation and dose reduction groups. There was a significant difference in survival time from the start of nintedanib administration, with a shorter survival time in the discontinuation group. In addition, the incidence of acute exacerbations was lower in the continuation and the dose reduction groups than in the discontinuation group. Developing an acute exacerbation and discontinuation of nintedanib administration were identified as poor prognostic factors. Conclusion: Even in patients with ILD who would be excluded due to selection bias, continuing nintedanib might show positive effects on survival. The results obtained in this study are considered worthy of further verification.