Nintedanib slows progression of lung function decline in patients with progressive fibrosing interstitial lung disease (PF-ILD) and was recommended for this indication within the NHS in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting.
Twenty-six UK centres were invited to take part in a national service evaluation between 17/11/21 and 30/09/22. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability was collected via electronic survey.
Twenty-four UK prescribing centres responded to the service evaluation invitation. Between 17/11/2021 and 30/09/2022, 1120 patients received a multi-disciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298/1120,26.6%), connective tissue disease associated interstitial lung disease (197/1120,17.6%), rheumatoid arthritis associated ILD (180/1120,16.0%), idiopathic non-specific interstitial pneumonia (125/1120,11.1%) and unclassifiable ILD (100/1120,8.9%). Of these, 54.4% (609/1120) were receiving concomitant corticosteroids, 355/1120 (31.7%) were receiving concomitant mycophenolate mofetil and 340/1120 (30.3%) were receiving another
immunosuppressive/modulatory therapy. Radiological progression of ILD
combined with worsening respiratory symptoms was the most common
reason for the diagnosis of PF-ILD.
We have demonstrated the use of nintedanib for the treatment of PFILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting.
|Journal||European Respiratory Journal|
|Publication status||Accepted/In press - 17 Oct 2023|