Assessing prognostic factors correlating with response to nintedanib for connective tissue disease-associated interstitial lung disease: A real-world single-center study

Int J Rheum Dis. 2023 Apr;26(4):682-688. doi: 10.1111/1756-185X.14611. Epub 2023 Feb 20.

Abstract

Objective: For patients with connective tissue disease-associated interstitial lung disease (CTD-ILD), early medical intervention would be desirable. This study analyzed the real-world, single-center use of nintedanib for CTD-ILD patients.

Methods: Patients with CTD who received nintedanib from January 2020 to July 2022 were enrolled. Medical records review and stratified analyses of the collected data were conducted.

Results: Reduction in the percentage of predicted forced vital capacity (%FVC) was seen in the elderly group (>70 years; P = .210), males (P = .027), the late group who started nintedanib >80 months after confirmation of an ILD disease activity (P = .03), the severe %DLco (diffusing capacity for carbon monoxide as a percentage of predicted) group (<40%; P = .20), the group who had extensive pulmonary fibrosis at the beginning of nintedanib (pulmonary fibrosis score >35%), and the low-dose group (nintedanib 50-100 mg/d; P = .40). %FVC did not decrease by >5% in the young group (<55 years), the early group who started nintedanib within 10 months after confirmation of an ILD disease activity, and the group whose pulmonary fibrosis score at the beginning of nintedanib was <35%.

Conclusion: It is important to diagnose ILD early and start antifibrotic drugs with proper timing for cases in need. It is better to start nintedanib early, especially for patients at risk (>70 years old, male, <40% DLco, and >35% areas of pulmonary fibrosis).

Keywords: connective tissue disease; drug use results survey; interstitial lung disease; nintedanib.

MeSH terms

  • Aged
  • Connective Tissue Diseases* / complications
  • Connective Tissue Diseases* / diagnosis
  • Connective Tissue Diseases* / drug therapy
  • Humans
  • Lung Diseases, Interstitial* / diagnosis
  • Lung Diseases, Interstitial* / drug therapy
  • Lung Diseases, Interstitial* / etiology
  • Male
  • Prognosis
  • Pulmonary Fibrosis*
  • Vital Capacity

Substances

  • nintedanib