Nintedanib Reveals Remarkable Efficacy in Alleviating Progressive Pulmonary Fibrosis Symptoms

In the groundbreaking INBUILD trial, researchers discovered that nintedanib can significantly improve the lives of patients suffering from progressive pulmonary fibrosis (PPF). Nintedanib holds promise not only in reducing the progression of dyspnea, fatigue, and cough but also in mitigating the overall impact of ILD over 52 weeks in patients grappling with PPF.

The trial results were published in the journal European Respiratory Journal. 

Pulmonary fibrosis, a condition characterized by scarring of the lungs, often leads to symptoms such as dyspnea (shortness of breath) and cough, profoundly impacting patients' daily lives. Hence, researchers conducted a trial, that focused on the effects of nintedanib on PPF symptoms using the Living with Pulmonary Fibrosis (L-PF) questionnaire to assess changes in patients' conditions.

The trial included 663 patients with fibrosing interstitial lung disease (ILD), excluding idiopathic pulmonary fibrosis, but with more than 10% lung involvement on high-resolution computed tomography (HRCT) scans and evidence of ILD progression within the past 24 months. Patients were randomly assigned to receive either nintedanib or a placebo, with researchers analyzing L-PF questionnaire scores from baseline to week 52 using mixed models for repeated measures.

Findings:         

• The results revealed a significant positive impact of nintedanib on patients' lives compared to the placebo group.
• Those receiving nintedanib experienced smaller increases (worsenings) in adjusted mean L-PF questionnaire total scores (0.5 versus 5.1) at week 52.         
• This trend was also observed in symptom scores (1.3 versus 5.3), dyspnea (4.3 versus 7.8), and fatigue (0.7 versus 4.0).          
• One notable finding was the decrease in L-PF questionnaire cough score in the nintedanib group, in stark contrast to the placebo group where cough scores increased (-1.8 versus 4.3).          
• Additionally, the impacts of ILD, as assessed by the L-PF questionnaire impact score, decreased slightly in the nintedanib group while increasing in the placebo group (-0.2 versus 4.6).       
• These positive outcomes were consistent across different patient subgroups, including those with a usual interstitial pneumonia-like fibrotic pattern on HRCT and those with other fibrotic patterns on HRCT.

The findings suggest that nintedanib has the potential to not only reduce the worsening of dyspnea, fatigue, and cough but also mitigate the overall impact of ILD over 52 weeks in patients with progressive pulmonary fibrosis. This breakthrough offers hope to individuals grappling with the debilitating effects of pulmonary fibrosis, as it paves the way for improved treatment strategies and enhanced quality of life for those affected by this challenging respiratory condition. As researchers continue to unravel the complexities of pulmonary fibrosis, advancements like these represent a significant step forward in the pursuit of better therapeutic options and increased well-being for patients.

Further reading: Effects of nintedanib on symptoms in patients with progressive pulmonary fibrosis. DOI: 10.1183/13993003.00752-2023