Nintedanib effective and safe for elderly patients with idiopathic pulmonary fibrosis

Researchers have found in a new research that Nintedanib is effective and safe for elderly patients with idiopathic pulmonary fibrosis with clinical outcomes similar to younger patients. The study was published in the journal Respiration.  

Idiopathic pulmonary fibrosis (IPF) primarily affects old patients with old age being one of the predictors of mortality. Nintedanib can slow the progression of IPF by reducing the rate of decline in forced vital capacity (FVC) and the risk of exacerbations. It is the only antifibrotic drug approved in Italy for patients aged >80 years. Hence researchers from Italy conducted an observational, retrospective, multicenter study on 159 patients. 

The decline of FVC was compared after 12 months of nintedanib in older patients aged >80 years versus younger patients. Differences related to other functional data, safety, tolerability, hospitalizations, exacerbations, and mortality were also evaluated.  

Results: 

• Out of 159, there were 122 [76.7%] male patients. 
• There were 106 (66.7%) aged ≤80 years and 53 (33.3%) aged >80 years among all.
• After 12 months of therapy, FVC decline was not significantly different (-45 mL [-170; 75] vs. -20 mL [-138; 110] mL; p: 0.51).
• There were no differences for other functional data too.
• The most frequent adverse event (AE) was diarrhea.
• The rate and type of any AEs, permanent/temporary dose reduction or drug discontinuation were not significantly different between patients aged ≤80 vs. >80 years.
• Furthermore, acute exacerbations, hospitalization, and mortality were not significantly different. 

Thus, when clinical outcomes were compared to those of younger patients, Nintedanib was found to be safe and effective in older IPF patients over 80. Therefore, IPF patients should not be prevented from receiving antifibrotic medication early because of their advanced age. 

Further reading: Mondoni M, Alfano F, Varone F, et al. Observational, Multicenter Study on the Efficacy, Tolerability, and Safety of Nintedanib in Patients with Idiopathic Pulmonary Fibrosis Older than 80 Years [published online ahead of print, 2022 Nov 10]. Respiration. 2022;1-9. doi: 10.1159/000527308