SSc-ILD Patients Treated with Nintedanib at high risk of weight loss and malnutrition

In a recent study published in the Arthritis Care & Research found the impact of nintedanib treatment on adverse events (AEs) and the risk of malnutrition in patients with systemic sclerosis–associated interstitial lung disease (SSc–ILD) based on their baseline body mass index (BMI).

The study investigated patients with SSc–ILD randomized to receive either nintedanib or a placebo over a span of 52 weeks, scrutinized AEs in two subgroups: those with a baseline BMI ≤20 kg/m² and those with a baseline BMI >20 kg/m². Additionally, the risk of malnutrition was assessed using a modified version of the Malnutrition Universal Screening Tool (MUST).

Remarkably, the analysis unveiled that the AE profile of nintedanib was comparable in both subgroups, regardless of baseline BMI. In the subgroup with a baseline BMI ≤20 kg/m², AEs resulted in treatment discontinuation for 16.7% of the nintedanib group, as opposed to 13.5% in the placebo group. In the subgroup with a baseline BMI >20 kg/m², these figures stood at 15.9% for nintedanib and 8.0% for placebo.

Utilizing the modified MUST, the study revealed that the majority of patients in both the nintedanib and placebo groups maintained a low risk of malnutrition throughout the 52-week period, with 74.0% and 78.1% respectively. However, a noteworthy finding was that in the nintedanib group, 4.5% of patients classified as low risk at baseline were categorized as high risk by their last assessment, whereas this percentage was only 1.0% in the placebo group.

In light of these findings, the SENSCIS trial underscores the importance of managing disease manifestations and AEs that could be associated with weight loss in SSc–ILD patients. While the majority of patients remained at a low risk of malnutrition over the course of the study, the proportion classified as high risk was notably higher among those receiving nintedanib compared to the placebo group. This revelation emphasizes the need for vigilant monitoring and proactive intervention to mitigate the risk of malnutrition in patients with SSc–ILD, especially those undergoing nintedanib treatment.

Source:

Volkmann, E. R., McMahan, Z. H., Smith, V., Jouneau, S., Miede, C., Alves, M., & Herrick, A. L. (2023). Risk of Malnutrition in Patients With Systemic Sclerosis‐Associated Interstitial Lung Disease Treated With Nintedanib in the Randomized, Placebo‐Controlled SENSCIS Trial. In Arthritis Care & Research. Wiley. https://doi.org/10.1002/acr.25176