Real-world of Nintedanib in a Spanish non-IPF progressive pulmonary fibrosis cohort

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Introduction: Nintedanib is recently approved as antifibrotic (AF) treatment for Progressive Pulmonary fibrosis (PPF). Aims: To analyse clinic and functional progression of different interstitial lung diseases (ILD) with PPF before and after the AF treatment. Methods: Unicentric, retrospective, observational and longitudinal study. Data of 111 patients from ILD-Unit of University Hospital of Bellvitge (BCN, Spain) were collected since 2015 to 2020 at three times: start of AF treatment, 1 year before and 1 year after its initiation. Slope drop of function test and dyspnea were analysed. Results: Fifty-five patients initiated Nintedanib because of PPF. Main ILD diagnosis were: CTD-ILD (36.4%), Unclassifiable ILD (16.4%), fibrotic hypersensitivity pneumonitis (12.7%), pneumoconiosis (7,3%), smoking-related ILD (5,5%), CPFE (5,5%), FEPP (5,5%), among others. Medians of FVC and DLCO at AF start were 82% [Q1 70.75;Q3 99.25] and 49% [Q1 40.5; Q3 57.62] of predicted, respectively. The slope down of FVC and DLCO observed 1 year before starting nintedanib was reduced the year after its initiation: FVC (-2.3% year before starting; 0,61% the year after; IC [-4.74;10.62]); DLCO (-7% before; -3.76% after; IC [-7.43;13.92]). Clinically, 28.8% of patients improved dyspnea after 1 year of AF treatment, 38.5% perceive the same symptoms and 26.9% worsened compared to the year before its initiation (77.8%). There were no significant changes in the O2 requirements at exertion comparing the year before starting nintedanib with the year after. Conclusions: Nintedanib reduces the slope down of FVC and DLCO the year after its initiation. Patients with 1 year of AF treatment presented less dyspnea than the previous year.

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