Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK
Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK
Background: nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting.
Methods: 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey.
Results: 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD.
Conclusion: we have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting.
Dixon, Giles
f8ab2ed2-8a8c-47e6-aac8-f30c0ab88434
Hague, Samuel
035fc872-e5ae-4cee-b7f6-f5d0fcb22a26
Mulholland, Sarah
92732b30-22f2-4bbd-9472-b25999c0bc96
Fletcher, Sophie V.
d05721e8-8943-4f13-a1f5-4ba183741c89
15 January 2024
Dixon, Giles
f8ab2ed2-8a8c-47e6-aac8-f30c0ab88434
Hague, Samuel
035fc872-e5ae-4cee-b7f6-f5d0fcb22a26
Mulholland, Sarah
92732b30-22f2-4bbd-9472-b25999c0bc96
Fletcher, Sophie V.
d05721e8-8943-4f13-a1f5-4ba183741c89
Dixon, Giles, Hague, Samuel and Mulholland, Sarah
,
et al.
(2024)
Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK.
ERJ Open Research, 10 (1), [00529-2023].
(doi:10.1183/23120541.00529-2023).
Abstract
Background: nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting.
Methods: 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey.
Results: 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD.
Conclusion: we have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting.
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Accepted/In Press date: 17 October 2023
e-pub ahead of print date: 15 January 2024
Published date: 15 January 2024
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Local EPrints ID: 486469
URI: http://eprints.soton.ac.uk/id/eprint/486469
ISSN: 2312-0541
PURE UUID: 5e17effe-df7a-4e88-abf9-d5d08f09423f
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Date deposited: 24 Jan 2024 17:31
Last modified: 11 Apr 2024 16:51
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Author:
Giles Dixon
Author:
Samuel Hague
Author:
Sarah Mulholland
Author:
Sophie V. Fletcher
Corporate Author: et al.
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