Real-world evidence of the antifibrotic nintedanib in rheumatoid arthritis-interstitial lung disease. National multicenter study of 74 patients
Authors' conclusion
Nintedanib seems to be effective and relatively safe in progressive fibrosing RA-ILD despite clinical differences with the INBUILD trial.
Study context
- Population
- Patients with RA-ILD and a progressive fibrosing phenotype in clinical practice, Spain74 in cohort
- Participants
- 74 vs 89
- Exposure
- Nintedanib-treated RA-ILD cohort vs RA-ILD patients of the INBUILD trial
- Nintedanibn = 74
- INBUILDn = 89reference
- Outcome
- FVC evolution
Methodological detailsnational multicentre, real-world clinical practice, comparison with INBUILD trial RA-ILD patients
- National multicentre
- Real-world clinical practice
- Comparison with INBUILD trial RA-ILD patients
Main finding
As reported in the abstract
FVC (% pred.) · median follow-up of 15 [10-22, 4-9] months
Mean forced vital capacity (FVC) one year before nintedanib start (% pred.)
81.9 ± 21.2
Mean baseline FVC (% pred.)
73.7 ± 22.5
Observational data: associations, not effects.
Further findings
- Retention rate — Nintedanib
- 78.4 %
Interstitial lung disease (ILD) progression or progressive pulmonary fibrosis · during follow-up
- Patients with ILD progression or progressive pulmonary fibrosis
- 16.7 %
DLCO · median follow-up 15 months
- No significant decline in mean DLCO; evolution significantly differed from a predictive model assuming changes without the drug
Comparison with INBUILD RA-ILD patients
- Clinical-practice patients older, higher tobacco exposure, longer time since ILD diagnosis, more frequent combined immunosuppressants
- Baseline mean FVC and DLCO similar in both groups
Safety
Reason for nintedanib discontinuation
- Gastrointestinal adverse events were the most common reason for discontinuation
Original publication
Real-world evidence of the antifibrotic nintedanib in rheumatoid arthritis-interstitial lung disease. National multicenter study of 74 patients. Semin Arthritis Rheum. Published 14 March 2025. doi:10.
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