Nintedanib for Pulmonary Parenchymal Fibrosis: Real-World Use vs. Trials
okay, here’s a breakdown of the key information from the provided text, focusing on the study’s findings and comparisons too the INBUILD trial:
Main Points:
* Study Focus: This study examined real-world data on patients treated with nintedanib for progressive fibrosing interstitial lung diseases (PF-ILD).
* Radiological Patterns Differ: A significant difference was found in the radiological patterns of patients compared to the INBUILD trial. this study showed fibrotic NSIP was predominant (58%), while the INBUILD trial had mostly UIP (62.1%).
* Dosage Issues: A ample number of patients in this study did not receive the full recommended dose of nintedanib (150mg twice daily). only 47% of patients with known dosage were on the full dose; the rest (10 patients) were on a reduced dose of 100mg twice daily.
* Discontinuation Rate: The rate of patients stopping nintedanib due to side effects (6 out of 30) was similar to the INBUILD trial.
* Efficacy of Reduced Doses: The authors highlight a lack of robust data on the effectiveness of lower nintedanib doses, noting it hasn’t been well-studied in randomized controlled trials. They mention some existing
comparison to INBUILD Trial:
| Feature | INBUILD Trial | This Study |
|---|---|---|
| Predominant Pattern | UIP (62.1%) | NSIP (58%) |
| full Dose Usage | Not specified | 47% |
| Discontinuation Rate | Similar | similar |
Links Mentioned:
* INBUILD clinical trial: https://www.nejm.org/doi/10.1056/NEJMoa1908681
* Real-world evidence: https://www.resmedjournal.com/article/S0954-6111(22)00280-3/fulltext00280-3/fulltext)
In essence, the study suggests that real-world nintedanib use differs from the controlled surroundings of the INBUILD trial, particularly in the types of lung disease patterns observed and the frequency of dose reduction. this raises questions about the generalizability of INBUILD trial results and the need for more research on the efficacy of lower nintedanib doses.