Indications for cessation and/or dose reduction for adverse events from Nintedanib for the treatment for Idiopathic Pulmonary Fibrosis

Title: Indications for cessation and/or dose reduction for adverse events from Nintedanib for the treatment for Idiopathic Pulmonary Fibrosis
Author(s): S.Green, L. Fox and K.M.A O’Reilly
Institution: Mater Misericordiae University Hospital, Dublin
Poster: Click to view poster
Category: Lung Cancer/CF/ILD/Surgery
Abstract: Title: Indications for cessation and/or dose reduction for adverse events from Nintedanib for the treatment for Idiopathic Pulmonary Fibrosis

Authors: S.Green, K.M.A. O’Reilly and L. Fox
Respiratory Department, Mater Misericordiae University Hospital, Dublin

Abstract:
Nintedanib has been shown in both clinical trials and real world experience to be a well-tolerated treatment that slows the rate of progression in Idiopathic Pulmonary Fibrosis (IPF). The most common adverse event reported is diarrhoea, occurring in 50-65%1. Experts report that approximately one third of patients discontinue antifibrotic therapies because of side effects.

In order to better understand our patients’ experience and potentially identify factors that might improve tolerability, we reviewed 26 patients (19M, 7F,) with IPF receiving Nintedanib at our institution between 2015 to 2020.

They had a median age of 69.50 years and 80.7% (n=21) had at least one comorbidity: 65.3% reported at least one adverse event; diarrhoea 34.6% (n=9), weight loss 30.7% (n=8), nausea 19.2% (n=5), deranged liver enzymes 7.6% (n=2), anorexia 3.8% (n=1), gout 3.8% (n=1). Twelve patients (46.1%) had at least one interruption to treatment, 5 patients (19.2%) continue on a reduced dose and 2 patients (7.6%) stopped treatment completely due to deranged LFTs and diarrhoea.

Therefore in our experience the majority of patients who experience a side effect related to Nintedanib therapy benefit from a temporary cessation of treatment, followed by recommencement of treatment at full or reduced dose.

References:
Rivera-Ortega P, Hayton C, Blaikley J, Leonard C, Chaudhuri N. Nintedanib in the management of idiopathic pulmonary fibrosis: clinical trial evidence and real-world experience. Ther Adv Respir Dis. 2018;12:1753466618800618. doi:10.1177/1753466618800618
Voice introduction: