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Open Access 28-09-2024 | Nintedanib | Review

Patient Profile-Based Management with Nintedanib in Patients with Idiopathic Pulmonary Fibrosis

Authors: Vinod K. Viswanathan, Aloke G. Ghoshal, Anant Mohan, Ketaki Patil, Chaitanya Bhargave, Sanjay Choudhari, Suyog Mehta

Published in: Pulmonary Therapy

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Abstract

A severe and progressive interstitial lung disease (ILD) known as idiopathic pulmonary fibrosis (IPF) has an unknown etiology with poorly defined mechanisms of development. Among the currently prescribed pharmacological interventions for IPF, nintedanib demonstrates the ability to decelerate the deterioration of lung function and yield positive clinical outcomes. Multiple randomized placebo-controlled trials have confirmed the efficacy and acceptable safety profile of nintedanib. Real-world evidence studies also support the use of nintedanib in IPF, being an efficient and well-tolerated treatment option. It has the potential to stabilize the disease progression in patients with ILD. Patients with IPF frequently have comorbidities like diabetes and hypertension, which can exacerbate the course of disease, reduce quality of life, and decrease treatment adherence. For well-informed decision-making, it is important for healthcare professionals to recognize the position of nintedanib therapy in IPF with comorbidities. The gastrointestinal adverse effects, notably diarrhea, dominate the nintedanib safety profile. These can be effectively controlled by closely monitoring side effects, administering anti-diarrheal and anti-emetic drugs, reducing the nintedanib dose, and discontinuing it in case of severe symptoms with an option to reintroduce the treatment after side effects subside. Symptomatic interventions and monitoring of liver enzymes may reduce the occurrence of permanent treatment discontinuations.
Literature
1.
go back to reference Samarelli AV, Tonelli R, Marchioni A, Bruzzi G, Gozzi F, Andrisani D, et al. Fibrotic idiopathic interstitial lung disease: The molecular and cellular key players. Int J Mol Sci. 2021;22:8952.PubMedPubMedCentralCrossRef Samarelli AV, Tonelli R, Marchioni A, Bruzzi G, Gozzi F, Andrisani D, et al. Fibrotic idiopathic interstitial lung disease: The molecular and cellular key players. Int J Mol Sci. 2021;22:8952.PubMedPubMedCentralCrossRef
2.
go back to reference Kang HK, Song JW. Progressive pulmonary fibrosis: where are we now? Tuberc Respir Dis (Seoul). 2024;87:123.PubMedCrossRef Kang HK, Song JW. Progressive pulmonary fibrosis: where are we now? Tuberc Respir Dis (Seoul). 2024;87:123.PubMedCrossRef
3.
go back to reference Maher TM, Bendstrup E, Dron L, Langley J, Smith G, Khalid JM, et al. Global incidence and prevalence of idiopathic pulmonary fibrosis. Respir Res. 2021;22:1–10.CrossRef Maher TM, Bendstrup E, Dron L, Langley J, Smith G, Khalid JM, et al. Global incidence and prevalence of idiopathic pulmonary fibrosis. Respir Res. 2021;22:1–10.CrossRef
4.
go back to reference Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, et al. Interstitial lung disease in India. Results of a prospective registry. Am J Respir Crit Care Med. 2017;195:801–13.PubMedCrossRef Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, et al. Interstitial lung disease in India. Results of a prospective registry. Am J Respir Crit Care Med. 2017;195:801–13.PubMedCrossRef
5.
go back to reference Dhooria S, Sehgal IS, Agarwal R, Muthu V, Prasad KT, Kathirvel S, et al. Incidence, prevalence, and national burden of interstitial lung diseases in India: estimates from two studies of 3089 subjects. PLoS ONE. 2022;17: e0271665.PubMedPubMedCentralCrossRef Dhooria S, Sehgal IS, Agarwal R, Muthu V, Prasad KT, Kathirvel S, et al. Incidence, prevalence, and national burden of interstitial lung diseases in India: estimates from two studies of 3089 subjects. PLoS ONE. 2022;17: e0271665.PubMedPubMedCentralCrossRef
6.
go back to reference Abuserewa ST, Duff R, Becker G, Duff III R. Treatment of idiopathic pulmonary fibrosis. Cureus. 2021;13(5):e15360. Abuserewa ST, Duff R, Becker G, Duff III R. Treatment of idiopathic pulmonary fibrosis. Cureus. 2021;13(5):e15360.
7.
go back to reference Richeldi L, Costabel U, Selman M, Kim DS, Hansell DM, Nicholson AG, et al. Efficacy of a tyrosine kinase inhibitor in idiopathic pulmonary fibrosis. N Engl J Med. 2011;365:1079–87.PubMedCrossRef Richeldi L, Costabel U, Selman M, Kim DS, Hansell DM, Nicholson AG, et al. Efficacy of a tyrosine kinase inhibitor in idiopathic pulmonary fibrosis. N Engl J Med. 2011;365:1079–87.PubMedCrossRef
8.
go back to reference Richeldi L, Du Bois RM, Raghu G, Azuma A, Brown KK, Costabel U, et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med. 2014;370:2071–82.PubMedCrossRef Richeldi L, Du Bois RM, Raghu G, Azuma A, Brown KK, Costabel U, et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med. 2014;370:2071–82.PubMedCrossRef
9.
go back to reference Richeldi L, Collard HR, Jones MG. Idiopathic pulmonary fibrosis. The Lancet. 2017;389:1941–52.CrossRef Richeldi L, Collard HR, Jones MG. Idiopathic pulmonary fibrosis. The Lancet. 2017;389:1941–52.CrossRef
10.
go back to reference Rodríguez-Portal JA. Efficacy and safety of nintedanib for the treatment of idiopathic pulmonary fibrosis: an update. Drugs R D. 2018;18:19–25.PubMedCrossRef Rodríguez-Portal JA. Efficacy and safety of nintedanib for the treatment of idiopathic pulmonary fibrosis: an update. Drugs R D. 2018;18:19–25.PubMedCrossRef
11.
go back to reference Idiopathic Pulmonary Fibrosis Clinical Research Network. Prednisone, azathioprine, and N-acetylcysteine for pulmonary fibrosis. N Engl J Med. 2012;366:1968–77.CrossRef Idiopathic Pulmonary Fibrosis Clinical Research Network. Prednisone, azathioprine, and N-acetylcysteine for pulmonary fibrosis. N Engl J Med. 2012;366:1968–77.CrossRef
12.
go back to reference Tzouvelekis A, Bouros E, Oikonomou A, Ntolios P, Zacharis G, Kolios G, et al. Effect and safety of mycophenolate mofetil in idiopathic pulmonary fibrosis. Pulm Med. 2011;2011(1):849035. Tzouvelekis A, Bouros E, Oikonomou A, Ntolios P, Zacharis G, Kolios G, et al. Effect and safety of mycophenolate mofetil in idiopathic pulmonary fibrosis. Pulm Med. 2011;2011(1):849035.
13.
go back to reference Naccache J-M, Jouneau S, Didier M, Borie R, Cachanado M, Bourdin A, et al. Cyclophosphamide added to glucocorticoids in acute exacerbation of idiopathic pulmonary fibrosis (EXAFIP): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med. 2022;10:26–34.PubMedCrossRef Naccache J-M, Jouneau S, Didier M, Borie R, Cachanado M, Bourdin A, et al. Cyclophosphamide added to glucocorticoids in acute exacerbation of idiopathic pulmonary fibrosis (EXAFIP): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med. 2022;10:26–34.PubMedCrossRef
16.
go back to reference Glass DS, Grossfeld D, Renna HA, Agarwala P, Spiegler P, DeLeon J, et al. Idiopathic pulmonary fibrosis: Current and future treatment. Clin Respir J. 2022;16:84–96.PubMedPubMedCentralCrossRef Glass DS, Grossfeld D, Renna HA, Agarwala P, Spiegler P, DeLeon J, et al. Idiopathic pulmonary fibrosis: Current and future treatment. Clin Respir J. 2022;16:84–96.PubMedPubMedCentralCrossRef
17.
go back to reference Laurenson S, Sidhu R, Goodall M, Adler AI. NICE guidance on nintedanib for treating idiopathic pulmonary fibrosis. Lancet Respir Med. 2016;4:176–7.PubMedCrossRef Laurenson S, Sidhu R, Goodall M, Adler AI. NICE guidance on nintedanib for treating idiopathic pulmonary fibrosis. Lancet Respir Med. 2016;4:176–7.PubMedCrossRef
21.
go back to reference Wongkarnjana A, Yanagihara T, Kolb MRJ. Treatment of idiopathic pulmonary fibrosis with Nintedanib: an update. Expert Rev Respir Med. 2019;13:1139–46.PubMedCrossRef Wongkarnjana A, Yanagihara T, Kolb MRJ. Treatment of idiopathic pulmonary fibrosis with Nintedanib: an update. Expert Rev Respir Med. 2019;13:1139–46.PubMedCrossRef
23.
go back to reference Huang J, Maier C, Zhang Y, Soare A, Dees C, Beyer C, et al. Nintedanib inhibits macrophage activation and ameliorates vascular and fibrotic manifestations in the Fra2 mouse model of systemic sclerosis. Ann Rheum Dis. 2017;76:1941–8.PubMedCrossRef Huang J, Maier C, Zhang Y, Soare A, Dees C, Beyer C, et al. Nintedanib inhibits macrophage activation and ameliorates vascular and fibrotic manifestations in the Fra2 mouse model of systemic sclerosis. Ann Rheum Dis. 2017;76:1941–8.PubMedCrossRef
24.
go back to reference Distler O, Highland KB, Gahlemann M, Azuma A, Fischer A, Mayes MD, et al. Nintedanib for systemic sclerosis–associated interstitial lung disease. N Engl J Med. 2019;380:2518–28.PubMedCrossRef Distler O, Highland KB, Gahlemann M, Azuma A, Fischer A, Mayes MD, et al. Nintedanib for systemic sclerosis–associated interstitial lung disease. N Engl J Med. 2019;380:2518–28.PubMedCrossRef
25.
go back to reference Wind S, Schmid U, Freiwald M, Marzin K, Lotz R, Ebner T, et al. Clinical pharmacokinetics and pharmacodynamics of nintedanib. Clin Pharmacokinet. 2019;58:1131–47.PubMedPubMedCentralCrossRef Wind S, Schmid U, Freiwald M, Marzin K, Lotz R, Ebner T, et al. Clinical pharmacokinetics and pharmacodynamics of nintedanib. Clin Pharmacokinet. 2019;58:1131–47.PubMedPubMedCentralCrossRef
26.
go back to reference Lancaster L, Crestani B, Hernandez P, Inoue Y, Wachtlin D, Loaiza L, et al. Safety and survival data in patients with idiopathic pulmonary fibrosis treated with nintedanib: pooled data from six clinical trials. BMJ Open Respir Res. 2019;6: e000397.PubMedPubMedCentralCrossRef Lancaster L, Crestani B, Hernandez P, Inoue Y, Wachtlin D, Loaiza L, et al. Safety and survival data in patients with idiopathic pulmonary fibrosis treated with nintedanib: pooled data from six clinical trials. BMJ Open Respir Res. 2019;6: e000397.PubMedPubMedCentralCrossRef
27.
go back to reference Richeldi L, Kreuter M, Selman M, Crestani B, Kirsten A-M, Wuyts WA, et al. Long-term treatment of patients with idiopathic pulmonary fibrosis with nintedanib: results from the TOMORROW trial and its open-label extension. Thorax. 2018;73:581–3.PubMedCrossRef Richeldi L, Kreuter M, Selman M, Crestani B, Kirsten A-M, Wuyts WA, et al. Long-term treatment of patients with idiopathic pulmonary fibrosis with nintedanib: results from the TOMORROW trial and its open-label extension. Thorax. 2018;73:581–3.PubMedCrossRef
28.
go back to reference Crestani B, Quaresma M, Kaye M, Stansen W, Stowasser S, Kreuter M. Long-term treatment with nintedanib in patients with IPF: an update from INPULSIS®-ON 2016. Crestani B, Quaresma M, Kaye M, Stansen W, Stowasser S, Kreuter M. Long-term treatment with nintedanib in patients with IPF: an update from INPULSIS®-ON 2016.
29.
go back to reference Song JW, Ogura T, Inoue Y, Xu Z, Quaresma M, Stowasser S, et al. Long-term treatment with nintedanib in Asian patients with idiopathic pulmonary fibrosis: Results from INPULSIS®-ON. Respirology. 2020;25:410–6.PubMedCrossRef Song JW, Ogura T, Inoue Y, Xu Z, Quaresma M, Stowasser S, et al. Long-term treatment with nintedanib in Asian patients with idiopathic pulmonary fibrosis: Results from INPULSIS®-ON. Respirology. 2020;25:410–6.PubMedCrossRef
30.
go back to reference Antoniou K, Markopoulou K, Tzouvelekis A, Trachalaki A, Vasarmidi E, Organtzis J, et al. Efficacy and safety of nintedanib in a Greek multicentre idiopathic pulmonary fibrosis registry: a retrospective, observational, cohort study. ERJ Open Res 2020;6. Antoniou K, Markopoulou K, Tzouvelekis A, Trachalaki A, Vasarmidi E, Organtzis J, et al. Efficacy and safety of nintedanib in a Greek multicentre idiopathic pulmonary fibrosis registry: a retrospective, observational, cohort study. ERJ Open Res 2020;6.
31.
go back to reference Bonella F, Kreuter M, Hagmeyer L, Neurohr C, Keller C, Kohlhaeufl MJ, et al. Insights from the German compassionate use program of nintedanib for the treatment of idiopathic pulmonary fibrosis. Respiration. 2016;92:98–106.PubMedCrossRef Bonella F, Kreuter M, Hagmeyer L, Neurohr C, Keller C, Kohlhaeufl MJ, et al. Insights from the German compassionate use program of nintedanib for the treatment of idiopathic pulmonary fibrosis. Respiration. 2016;92:98–106.PubMedCrossRef
32.
go back to reference Brunnemer E, Wälscher J, Tenenbaum S, Hausmanns J, Schulze K, Seiter M, et al. Real-world experience with nintedanib in patients with idiopathic pulmonary fibrosis. Respiration. 2018;95:301–9.PubMedCrossRef Brunnemer E, Wälscher J, Tenenbaum S, Hausmanns J, Schulze K, Seiter M, et al. Real-world experience with nintedanib in patients with idiopathic pulmonary fibrosis. Respiration. 2018;95:301–9.PubMedCrossRef
33.
go back to reference Talwar D, Prajapat DK, Talwar D. Real world efficacy and safety of nintedanib in idiopathic pulmonary fibrosis: A single center, observational study from India. Lung India. 2022;39:27.PubMedCrossRef Talwar D, Prajapat DK, Talwar D. Real world efficacy and safety of nintedanib in idiopathic pulmonary fibrosis: A single center, observational study from India. Lung India. 2022;39:27.PubMedCrossRef
34.
go back to reference Kolonics-Farkas AM, Šterclová M, Mogulkoc N, Lewandowska K, Müller V, Hájková M, et al. Differences in baseline characteristics and access to treatment of newly diagnosed patients with IPF in the Empire countries. Front Med (Lausanne). 2021;8: 729203.PubMedCrossRef Kolonics-Farkas AM, Šterclová M, Mogulkoc N, Lewandowska K, Müller V, Hájková M, et al. Differences in baseline characteristics and access to treatment of newly diagnosed patients with IPF in the Empire countries. Front Med (Lausanne). 2021;8: 729203.PubMedCrossRef
35.
go back to reference Bocchino M, Bruzzese D, Scioscia G, Capitelli L, Tondo P, Rea G, et al. Disease stage-related survival in idiopathic pulmonary fibrosis patients treated with nintedanib and pirfenidone: An exploratory study. Respir Med Res. 2023;84: 101013.PubMed Bocchino M, Bruzzese D, Scioscia G, Capitelli L, Tondo P, Rea G, et al. Disease stage-related survival in idiopathic pulmonary fibrosis patients treated with nintedanib and pirfenidone: An exploratory study. Respir Med Res. 2023;84: 101013.PubMed
36.
go back to reference Singer D, Bengtson LGS, Conoscenti CS, Anderson AJ, Brekke L, Shetty SS, et al. Impact of timing of nintedanib initiation among patients newly diagnosed with idiopathic pulmonary fibrosis. J Med Econ. 2022;25:532–40.PubMedCrossRef Singer D, Bengtson LGS, Conoscenti CS, Anderson AJ, Brekke L, Shetty SS, et al. Impact of timing of nintedanib initiation among patients newly diagnosed with idiopathic pulmonary fibrosis. J Med Econ. 2022;25:532–40.PubMedCrossRef
37.
go back to reference Glaspole I, Bonella F, Bargagli E, Glassberg MK, Caro F, Stansen W, et al. Efficacy and safety of nintedanib in patients with idiopathic pulmonary fibrosis who are elderly or have comorbidities. Respir Res. 2021;22:1–10.CrossRef Glaspole I, Bonella F, Bargagli E, Glassberg MK, Caro F, Stansen W, et al. Efficacy and safety of nintedanib in patients with idiopathic pulmonary fibrosis who are elderly or have comorbidities. Respir Res. 2021;22:1–10.CrossRef
38.
go back to reference Kreuter M, Ehlers-Tenenbaum S, Palmowski K, Bruhwyler J, Oltmanns U, Muley T, et al. Impact of comorbidities on mortality in patients with idiopathic pulmonary fibrosis. PLoS ONE. 2016;11: e0151425.PubMedPubMedCentralCrossRef Kreuter M, Ehlers-Tenenbaum S, Palmowski K, Bruhwyler J, Oltmanns U, Muley T, et al. Impact of comorbidities on mortality in patients with idiopathic pulmonary fibrosis. PLoS ONE. 2016;11: e0151425.PubMedPubMedCentralCrossRef
39.
go back to reference Hyldgaard C, Hilberg O, Bendstrup E. How does comorbidity influence survival in idiopathic pulmonary fibrosis? Respir Med. 2014;108:647–53.PubMedCrossRef Hyldgaard C, Hilberg O, Bendstrup E. How does comorbidity influence survival in idiopathic pulmonary fibrosis? Respir Med. 2014;108:647–53.PubMedCrossRef
40.
go back to reference Wang D, Ma Y, Tong X, Zhang Y, Fan H. Diabetes mellitus contributes to idiopathic pulmonary fibrosis: a review from clinical appearance to possible pathogenesis. Front Public Health. 2020;8:196.PubMedPubMedCentralCrossRef Wang D, Ma Y, Tong X, Zhang Y, Fan H. Diabetes mellitus contributes to idiopathic pulmonary fibrosis: a review from clinical appearance to possible pathogenesis. Front Public Health. 2020;8:196.PubMedPubMedCentralCrossRef
41.
go back to reference Galli JA, Pandya A, Vega-Olivo M, Dass C, Zhao H, Criner GJ. Pirfenidone and nintedanib for pulmonary fibrosis in clinical practice: tolerability and adverse drug reactions. Respirology. 2017;22:1171–8.PubMedCrossRef Galli JA, Pandya A, Vega-Olivo M, Dass C, Zhao H, Criner GJ. Pirfenidone and nintedanib for pulmonary fibrosis in clinical practice: tolerability and adverse drug reactions. Respirology. 2017;22:1171–8.PubMedCrossRef
42.
go back to reference Barczi E, Starobinski L, Kolonics-Farkas A, Eszes N, Bohacs A, Vasakova M, et al. Long-term effects and adverse events of nintedanib therapy in idiopathic pulmonary fibrosis patients with functionally advanced disease. Adv Ther. 2019;36:1221–32.PubMedCrossRef Barczi E, Starobinski L, Kolonics-Farkas A, Eszes N, Bohacs A, Vasakova M, et al. Long-term effects and adverse events of nintedanib therapy in idiopathic pulmonary fibrosis patients with functionally advanced disease. Adv Ther. 2019;36:1221–32.PubMedCrossRef
43.
go back to reference Sangani RG, Ghio AJ, Mujahid H, Patel Z, Catherman K, Wen S, et al. Outcomes of idiopathic pulmonary fibrosis improve with obesity: a rural Appalachian experience. South Med J. 2021;114:424.PubMedPubMedCentralCrossRef Sangani RG, Ghio AJ, Mujahid H, Patel Z, Catherman K, Wen S, et al. Outcomes of idiopathic pulmonary fibrosis improve with obesity: a rural Appalachian experience. South Med J. 2021;114:424.PubMedPubMedCentralCrossRef
45.
go back to reference Noth I, Wijsenbeek M, Kolb M, Bonella F, Moros L, Wachtlin D, et al. Cardiovascular safety of nintedanib in subgroups by cardiovascular risk at baseline in the TOMORROW and INPULSIS trials. Eur Respir J. 2019;54(3):1801797. Noth I, Wijsenbeek M, Kolb M, Bonella F, Moros L, Wachtlin D, et al. Cardiovascular safety of nintedanib in subgroups by cardiovascular risk at baseline in the TOMORROW and INPULSIS trials. Eur Respir J. 2019;54(3):1801797.
46.
go back to reference Bendstrup E, Wuyts W, Alfaro T, Chaudhuri N, Cornelissen R, Kreuter M, et al. Nintedanib in idiopathic pulmonary fibrosis: practical management recommendations for potential adverse events. Respiration. 2019;97:173–84.PubMedCrossRef Bendstrup E, Wuyts W, Alfaro T, Chaudhuri N, Cornelissen R, Kreuter M, et al. Nintedanib in idiopathic pulmonary fibrosis: practical management recommendations for potential adverse events. Respiration. 2019;97:173–84.PubMedCrossRef
47.
go back to reference Cottin V, Selman M, Inoue Y, Wong AW, Corte TJ, Flaherty KR, et al. Syndrome of combined pulmonary fibrosis and emphysema: an official ATS/ERS/JRS/ALAT research statement. Am J Respir Crit Care Med. 2022;206:e7-41.PubMedCrossRef Cottin V, Selman M, Inoue Y, Wong AW, Corte TJ, Flaherty KR, et al. Syndrome of combined pulmonary fibrosis and emphysema: an official ATS/ERS/JRS/ALAT research statement. Am J Respir Crit Care Med. 2022;206:e7-41.PubMedCrossRef
48.
go back to reference Cottin V, Azuma A, Raghu G, Stansen W, Stowasser S, Schlenker-Herceg R, et al. Therapeutic effects of nintedanib are not influenced by emphysema in the INPULSIS trials. Eur Respir J. 2019;53(4):1801655. Cottin V, Azuma A, Raghu G, Stansen W, Stowasser S, Schlenker-Herceg R, et al. Therapeutic effects of nintedanib are not influenced by emphysema in the INPULSIS trials. Eur Respir J. 2019;53(4):1801655.
49.
go back to reference Senoo S, Miyahara N, Taniguchi A, Oda N, Itano J, Higo H, et al. Nintedanib can be used safely and effectively for idiopathic pulmonary fibrosis with predicted forced vital capacity≤ 50%: a multi-center retrospective analysis. PLoS ONE. 2020;15: e0236935.PubMedPubMedCentralCrossRef Senoo S, Miyahara N, Taniguchi A, Oda N, Itano J, Higo H, et al. Nintedanib can be used safely and effectively for idiopathic pulmonary fibrosis with predicted forced vital capacity≤ 50%: a multi-center retrospective analysis. PLoS ONE. 2020;15: e0236935.PubMedPubMedCentralCrossRef
50.
go back to reference Bonella F, Bendstrup E, Bargagli E, Stansen W, Quaresma M, Orsatti L, et al. Efficacy and safety of nintedanib in the elderly patient with IPF. Pneumologie. 2020;74:P167. Bonella F, Bendstrup E, Bargagli E, Stansen W, Quaresma M, Orsatti L, et al. Efficacy and safety of nintedanib in the elderly patient with IPF. Pneumologie. 2020;74:P167.
51.
go back to reference Komatsu M, Yamamoto H, Ichiyama T, Kawakami S, Uehara T, Yoshikawa Y, et al. Tolerability of nintedanib in the elderly with idiopathic pulmonary fibrosis: a single-center retrospective study. PLoS ONE. 2022;17: e0262795.PubMedPubMedCentralCrossRef Komatsu M, Yamamoto H, Ichiyama T, Kawakami S, Uehara T, Yoshikawa Y, et al. Tolerability of nintedanib in the elderly with idiopathic pulmonary fibrosis: a single-center retrospective study. PLoS ONE. 2022;17: e0262795.PubMedPubMedCentralCrossRef
52.
go back to reference Lehtonen ST, Veijola A, Karvonen H, Lappi-Blanco E, Sormunen R, Korpela S, et al. Pirfenidone and nintedanib modulate properties of fibroblasts and myofibroblasts in idiopathic pulmonary fibrosis. Respir Res. 2016;17:1–12.CrossRef Lehtonen ST, Veijola A, Karvonen H, Lappi-Blanco E, Sormunen R, Korpela S, et al. Pirfenidone and nintedanib modulate properties of fibroblasts and myofibroblasts in idiopathic pulmonary fibrosis. Respir Res. 2016;17:1–12.CrossRef
53.
go back to reference Bargagli E, Piccioli C, Rosi E, Torricelli E, Turi L, Piccioli E, et al. Pirfenidone and Nintedanib in idiopathic pulmonary fibrosis: real-life experience in an Italian referral centre. Pulmonology. 2019;25:149–53.PubMedCrossRef Bargagli E, Piccioli C, Rosi E, Torricelli E, Turi L, Piccioli E, et al. Pirfenidone and Nintedanib in idiopathic pulmonary fibrosis: real-life experience in an Italian referral centre. Pulmonology. 2019;25:149–53.PubMedCrossRef
54.
go back to reference Cerri S, Monari M, Guerrieri A, Donatelli P, Bassi I, Garuti M, et al. Real-life comparison of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis: a 24-month assessment. Respir Med. 2019;159: 105803.PubMedCrossRef Cerri S, Monari M, Guerrieri A, Donatelli P, Bassi I, Garuti M, et al. Real-life comparison of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis: a 24-month assessment. Respir Med. 2019;159: 105803.PubMedCrossRef
55.
go back to reference Rogliani P, Calzetta L, Cavalli F, Matera MG, Cazzola M. Pirfenidone, nintedanib and N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Pulm Pharmacol Ther. 2016;40:95–103.PubMedCrossRef Rogliani P, Calzetta L, Cavalli F, Matera MG, Cazzola M. Pirfenidone, nintedanib and N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Pulm Pharmacol Ther. 2016;40:95–103.PubMedCrossRef
56.
go back to reference Cameli P, Refini RM, Bergantini L, d’Alessandro M, Alonzi V, Magnoni C, et al. Long-term follow-up of patients with idiopathic pulmonary fibrosis treated with pirfenidone or nintedanib: a real-life comparison study. Front Mol Biosci. 2020;7: 581828.PubMedPubMedCentralCrossRef Cameli P, Refini RM, Bergantini L, d’Alessandro M, Alonzi V, Magnoni C, et al. Long-term follow-up of patients with idiopathic pulmonary fibrosis treated with pirfenidone or nintedanib: a real-life comparison study. Front Mol Biosci. 2020;7: 581828.PubMedPubMedCentralCrossRef
57.
go back to reference Santoleri F, Auriemma L, Spacone A, Marinari S, Esposito F, De Vita F, et al. Adherence, persistence, and effectiveness in real life. Multicenter long-term study on the use of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis. J Pharm Pract. 2022;35:853–8.PubMedCrossRef Santoleri F, Auriemma L, Spacone A, Marinari S, Esposito F, De Vita F, et al. Adherence, persistence, and effectiveness in real life. Multicenter long-term study on the use of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis. J Pharm Pract. 2022;35:853–8.PubMedCrossRef
58.
go back to reference Takehara K, Koga Y, Hachisu Y, Utsugi M, Sawada Y, Saito Y, et al. Differential discontinuation profiles between pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis. Cells. 2022;11:143.PubMedPubMedCentralCrossRef Takehara K, Koga Y, Hachisu Y, Utsugi M, Sawada Y, Saito Y, et al. Differential discontinuation profiles between pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis. Cells. 2022;11:143.PubMedPubMedCentralCrossRef
59.
go back to reference Marijic P, Schwarzkopf L, Schwettmann L, Ruhnke T, Trudzinski F, Kreuter M. Pirfenidone vs. nintedanib in patients with idiopathic pulmonary fibrosis: a retrospective cohort study. Respir Res. 2021;22:1–11.CrossRef Marijic P, Schwarzkopf L, Schwettmann L, Ruhnke T, Trudzinski F, Kreuter M. Pirfenidone vs. nintedanib in patients with idiopathic pulmonary fibrosis: a retrospective cohort study. Respir Res. 2021;22:1–11.CrossRef
60.
go back to reference Belhassen M, Dalon F, Nolin M, Van Ganse E. Comparative outcomes in patients receiving pirfenidone or nintedanib for idiopathic pulmonary fibrosis. Respir Res. 2021;22:1–11.CrossRef Belhassen M, Dalon F, Nolin M, Van Ganse E. Comparative outcomes in patients receiving pirfenidone or nintedanib for idiopathic pulmonary fibrosis. Respir Res. 2021;22:1–11.CrossRef
61.
go back to reference Górska K, Maskey-Warzęchowska M, Barnaś M, Białas A, Barczyk A, Jagielska-Len H, et al. Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland. Ther Adv Chronic Dis. 2022;13:20406223221117984.CrossRef Górska K, Maskey-Warzęchowska M, Barnaś M, Białas A, Barczyk A, Jagielska-Len H, et al. Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland. Ther Adv Chronic Dis. 2022;13:20406223221117984.CrossRef
62.
go back to reference Saito S, Alkhatib A, Kolls JK, Kondoh Y, Lasky JA. Pharmacotherapy and adjunctive treatment for idiopathic pulmonary fibrosis (IPF). J Thorac Dis. 2019;11:S1740.PubMedPubMedCentralCrossRef Saito S, Alkhatib A, Kolls JK, Kondoh Y, Lasky JA. Pharmacotherapy and adjunctive treatment for idiopathic pulmonary fibrosis (IPF). J Thorac Dis. 2019;11:S1740.PubMedPubMedCentralCrossRef
63.
go back to reference Flaherty KR, Fell CD, Huggins JT, Nunes H, Sussman R, Valenzuela C, et al. Safety of nintedanib added to pirfenidone treatment for idiopathic pulmonary fibrosis. Eur Respir J. 2018;52(2):1800230. Flaherty KR, Fell CD, Huggins JT, Nunes H, Sussman R, Valenzuela C, et al. Safety of nintedanib added to pirfenidone treatment for idiopathic pulmonary fibrosis. Eur Respir J. 2018;52(2):1800230.
64.
go back to reference Vancheri C, Kreuter M, Richeldi L, Ryerson CJ, Valeyre D, Grutters JC, et al. Nintedanib with add-on pirfenidone in idiopathic pulmonary fibrosis. Results of the INJOURNEY trial. Am J Respir Crit Care Med. 2018;197:356–63.PubMedCrossRef Vancheri C, Kreuter M, Richeldi L, Ryerson CJ, Valeyre D, Grutters JC, et al. Nintedanib with add-on pirfenidone in idiopathic pulmonary fibrosis. Results of the INJOURNEY trial. Am J Respir Crit Care Med. 2018;197:356–63.PubMedCrossRef
65.
go back to reference Hisata S, Bando M, Homma S, Kataoka K, Ogura T, Izumi S, et al. Safety and tolerability of combination therapy with pirfenidone and nintedanib for idiopathic pulmonary fibrosis: a multicenter retrospective observational study in Japan. Respir Investig. 2021;59:819–26.PubMedCrossRef Hisata S, Bando M, Homma S, Kataoka K, Ogura T, Izumi S, et al. Safety and tolerability of combination therapy with pirfenidone and nintedanib for idiopathic pulmonary fibrosis: a multicenter retrospective observational study in Japan. Respir Investig. 2021;59:819–26.PubMedCrossRef
66.
go back to reference Kolb M, Raghu G, Wells AU, Behr J, Richeldi L, Schinzel B, et al. Nintedanib plus sildenafil in patients with idiopathic pulmonary fibrosis. N Engl J Med. 2018;379:1722–31.PubMedCrossRef Kolb M, Raghu G, Wells AU, Behr J, Richeldi L, Schinzel B, et al. Nintedanib plus sildenafil in patients with idiopathic pulmonary fibrosis. N Engl J Med. 2018;379:1722–31.PubMedCrossRef
68.
go back to reference Behr J, Kolb M, Song JW, Luppi F, Schinzel B, Stowasser S, et al. Nintedanib and sildenafil in patients with idiopathic pulmonary fibrosis and right heart dysfunction. A prespecified subgroup analysis of a double-blind randomized clinical trial (INSTAGE). Am J Respir Crit Care Med. 2019;200:1505–12.PubMedPubMedCentralCrossRef Behr J, Kolb M, Song JW, Luppi F, Schinzel B, Stowasser S, et al. Nintedanib and sildenafil in patients with idiopathic pulmonary fibrosis and right heart dysfunction. A prespecified subgroup analysis of a double-blind randomized clinical trial (INSTAGE). Am J Respir Crit Care Med. 2019;200:1505–12.PubMedPubMedCentralCrossRef
70.
go back to reference Mullerpattan JB, Porwal SH, Sarkar TA, Wagh HD, Udwadia ZF. Use of nintedanib in patients with idiopathic pulmonary fibrosis: initial Indian experience. Lung India. 2019;36:465–6.PubMedPubMedCentralCrossRef Mullerpattan JB, Porwal SH, Sarkar TA, Wagh HD, Udwadia ZF. Use of nintedanib in patients with idiopathic pulmonary fibrosis: initial Indian experience. Lung India. 2019;36:465–6.PubMedPubMedCentralCrossRef
71.
go back to reference Corte T, Bonella F, Crestani B, Demedts MG, Richeldi L, Coeck C, et al. Safety, tolerability and appropriate use of nintedanib in idiopathic pulmonary fibrosis. Respir Res. 2015;16:1–10.CrossRef Corte T, Bonella F, Crestani B, Demedts MG, Richeldi L, Coeck C, et al. Safety, tolerability and appropriate use of nintedanib in idiopathic pulmonary fibrosis. Respir Res. 2015;16:1–10.CrossRef
72.
go back to reference Crestani B, Huggins JT, Kaye M, Costabel U, Glaspole I, Ogura T, et al. Long-term safety and tolerability of nintedanib in patients with idiopathic pulmonary fibrosis: results from the open-label extension study, INPULSIS-ON. Lancet Respir Med. 2019;7:60–8.PubMedCrossRef Crestani B, Huggins JT, Kaye M, Costabel U, Glaspole I, Ogura T, et al. Long-term safety and tolerability of nintedanib in patients with idiopathic pulmonary fibrosis: results from the open-label extension study, INPULSIS-ON. Lancet Respir Med. 2019;7:60–8.PubMedCrossRef
73.
go back to reference Grześk G, Woźniak-Wiśniewska A, Błażejewski J, Górny B, Wołowiec Ł, Rogowicz D, et al. The interactions of nintedanib and oral anticoagulants—Molecular mechanisms and clinical implications. Int J Mol Sci. 2020;22:282.PubMedPubMedCentralCrossRef Grześk G, Woźniak-Wiśniewska A, Błażejewski J, Górny B, Wołowiec Ł, Rogowicz D, et al. The interactions of nintedanib and oral anticoagulants—Molecular mechanisms and clinical implications. Int J Mol Sci. 2020;22:282.PubMedPubMedCentralCrossRef
74.
go back to reference Chen C-H, Lin H-C, Wang Y-H, Wang C-Y, Lin YS, Lai C-C. The safety of nintedanib for the treatment of interstitial lung disease: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE. 2021;16: e0251636.PubMedPubMedCentralCrossRef Chen C-H, Lin H-C, Wang Y-H, Wang C-Y, Lin YS, Lai C-C. The safety of nintedanib for the treatment of interstitial lung disease: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE. 2021;16: e0251636.PubMedPubMedCentralCrossRef
75.
go back to reference Lasky JA, Criner GJ, Lazarus HM, Kohlbrenner V, Bender S, Richeldi L. Safety of nintedanib in patients with idiopathic pulmonary fibrosis: global pharmacovigilance data. Adv Ther. 2020;37:4209–19.PubMedCrossRef Lasky JA, Criner GJ, Lazarus HM, Kohlbrenner V, Bender S, Richeldi L. Safety of nintedanib in patients with idiopathic pulmonary fibrosis: global pharmacovigilance data. Adv Ther. 2020;37:4209–19.PubMedCrossRef
76.
go back to reference Ntolios P, Archontogeorgis K, Anevlavis S, Bonelis K, Paxinou N, Voulgaris A, et al. Feasibility and safety of treatment switch from Pirfenidone to Nintedanib in patients with idiopathic pulmonary fibrosis: a real-world observational study. Eur Rev Med Pharmacol Sci 2021;25(20):6326–32. Ntolios P, Archontogeorgis K, Anevlavis S, Bonelis K, Paxinou N, Voulgaris A, et al. Feasibility and safety of treatment switch from Pirfenidone to Nintedanib in patients with idiopathic pulmonary fibrosis: a real-world observational study. Eur Rev Med Pharmacol Sci 2021;25(20):6326–32.
77.
go back to reference Milger K, Kneidinger N, Neurohr C, Reichenberger F, Behr J. Switching to nintedanib after discontinuation of pirfenidone due to adverse events in IPF. Eur Respir J. 2015;46:1217–21.PubMedCrossRef Milger K, Kneidinger N, Neurohr C, Reichenberger F, Behr J. Switching to nintedanib after discontinuation of pirfenidone due to adverse events in IPF. Eur Respir J. 2015;46:1217–21.PubMedCrossRef
78.
go back to reference Costabel U, Inoue Y, Richeldi L, Collard HR, Tschoepe I, Stowasser S, et al. Efficacy of nintedanib in idiopathic pulmonary fibrosis across prespecified subgroups in INPULSIS. Am J Respir Crit Care Med. 2016;193:178–85.PubMedCrossRef Costabel U, Inoue Y, Richeldi L, Collard HR, Tschoepe I, Stowasser S, et al. Efficacy of nintedanib in idiopathic pulmonary fibrosis across prespecified subgroups in INPULSIS. Am J Respir Crit Care Med. 2016;193:178–85.PubMedCrossRef
79.
go back to reference Rahaghi F, Belperio JA, Fitzgerald J, Gulati M, Hallowell R, Highland KB, et al. Delphi consensus recommendations on management of dosing, adverse events, and comorbidities in the treatment of idiopathic pulmonary fibrosis with nintedanib. Clin Med Insights Circ Respir Pulm Med. 2021;15:11795484211006050.PubMedPubMedCentralCrossRef Rahaghi F, Belperio JA, Fitzgerald J, Gulati M, Hallowell R, Highland KB, et al. Delphi consensus recommendations on management of dosing, adverse events, and comorbidities in the treatment of idiopathic pulmonary fibrosis with nintedanib. Clin Med Insights Circ Respir Pulm Med. 2021;15:11795484211006050.PubMedPubMedCentralCrossRef
80.
go back to reference Matteson EL, Aringer M, Burmester GR, Mueller H, Moros L, Kolb M. Effect of nintedanib in patients with progressive pulmonary fibrosis associated with rheumatoid arthritis: data from the INBUILD trial. Clin Rheumatol. 2023;42:2311–9.PubMedPubMedCentralCrossRef Matteson EL, Aringer M, Burmester GR, Mueller H, Moros L, Kolb M. Effect of nintedanib in patients with progressive pulmonary fibrosis associated with rheumatoid arthritis: data from the INBUILD trial. Clin Rheumatol. 2023;42:2311–9.PubMedPubMedCentralCrossRef
81.
go back to reference van Cleemput J, Sonaglioni A, Wuyts WA, Bengus M, Stauffer JL, Harari S. Idiopathic pulmonary fibrosis for cardiologists: differential diagnosis, cardiovascular comorbidities, and patient management. Adv Ther. 2019;36:298–317.PubMedCrossRef van Cleemput J, Sonaglioni A, Wuyts WA, Bengus M, Stauffer JL, Harari S. Idiopathic pulmonary fibrosis for cardiologists: differential diagnosis, cardiovascular comorbidities, and patient management. Adv Ther. 2019;36:298–317.PubMedCrossRef
82.
go back to reference Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med. 2022;205:e18-47.PubMedPubMedCentralCrossRef Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med. 2022;205:e18-47.PubMedPubMedCentralCrossRef
83.
go back to reference Homma S, Bando M, Azuma A, Sakamoto S, Sugino K, Ishii Y, et al. Japanese guideline for the treatment of idiopathic pulmonary fibrosis. Respir Investig. 2018;56:268–91.PubMedCrossRef Homma S, Bando M, Azuma A, Sakamoto S, Sugino K, Ishii Y, et al. Japanese guideline for the treatment of idiopathic pulmonary fibrosis. Respir Investig. 2018;56:268–91.PubMedCrossRef
85.
go back to reference Cottin V, Crestani B, Valeyre D, Wallaert B, Cadranel J, Dalphin J-C, et al. Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines. Eur Respir Rev. 2014;23:193–214.PubMedPubMedCentralCrossRef Cottin V, Crestani B, Valeyre D, Wallaert B, Cadranel J, Dalphin J-C, et al. Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines. Eur Respir Rev. 2014;23:193–214.PubMedPubMedCentralCrossRef
87.
go back to reference Singh S, Sharma BB, Bairwa M, Gothi D, Desai U, Joshi JM, et al. Management of interstitial lung diseases: a consensus statement of the Indian Chest Society (ICS) and National College of Chest Physicians (NCCP). Lung India. 2020;37:359.PubMedPubMedCentralCrossRef Singh S, Sharma BB, Bairwa M, Gothi D, Desai U, Joshi JM, et al. Management of interstitial lung diseases: a consensus statement of the Indian Chest Society (ICS) and National College of Chest Physicians (NCCP). Lung India. 2020;37:359.PubMedPubMedCentralCrossRef
88.
go back to reference Raghu G, Rochwerg B, Zhang Y, Garcia CAC, Azuma A, Behr J, et al. An official ATS/ERS/JRS/ALAT clinical practice guideline: treatment of idiopathic pulmonary fibrosis. An update of the 2011 clinical practice guideline. Am J Respir Crit Care Med. 2015;192:e3-19.PubMedCrossRef Raghu G, Rochwerg B, Zhang Y, Garcia CAC, Azuma A, Behr J, et al. An official ATS/ERS/JRS/ALAT clinical practice guideline: treatment of idiopathic pulmonary fibrosis. An update of the 2011 clinical practice guideline. Am J Respir Crit Care Med. 2015;192:e3-19.PubMedCrossRef
89.
go back to reference Maher TM, Stowasser S, Nishioka Y, White ES, Cottin V, Noth I, et al. Biomarkers of extracellular matrix turnover in patients with idiopathic pulmonary fibrosis given nintedanib (INMARK study): a randomised, placebo-controlled study. Lancet Respir Med. 2019;7:771–9.PubMedCrossRef Maher TM, Stowasser S, Nishioka Y, White ES, Cottin V, Noth I, et al. Biomarkers of extracellular matrix turnover in patients with idiopathic pulmonary fibrosis given nintedanib (INMARK study): a randomised, placebo-controlled study. Lancet Respir Med. 2019;7:771–9.PubMedCrossRef
Metadata
Title
Patient Profile-Based Management with Nintedanib in Patients with Idiopathic Pulmonary Fibrosis
Authors
Vinod K. Viswanathan
Aloke G. Ghoshal
Anant Mohan
Ketaki Patil
Chaitanya Bhargave
Sanjay Choudhari
Suyog Mehta
Publication date
28-09-2024
Publisher
Springer Healthcare
Published in
Pulmonary Therapy
Print ISSN: 2364-1754
Electronic ISSN: 2364-1746
DOI
https://doi.org/10.1007/s41030-024-00271-1

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