Real world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

Giles Dixon, Samuel Hague, Sarah Mulholland, Aye Myat Noe Khin, Hannah Thould, Roisin Connon, Paul Minnis, Eoin Murtagh, Fasihul Khan, Sameen Toor, Alexandra Lawrence, Marium Naqvi, Alex West, Robina Coker, Katie Ward, Leda Yazbeck, Simon Hart, Theresa Garfoot, Kate Newman, Pilar Rivera-OrtegaLachlan Stranks, Paul Beirne, Jessica Bradley, Catherine Rowan, Sarah Agnew, Mahin Ahmad, Lisa Spencer, Joshua Aigbirior, Ahmed Fahim, Andrew Wilson

Research output: Contribution to journalArticlepeer-review


Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.
Original languageEnglish
JournalEuropean Respiratory Journal
Issue numbersuppl 67
Publication statusPublished - 27 Oct 2023

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