AB1483 NINTEDANIB IN PROGRESSIVE PULMONARY FIBROSIS. COMPARING SUBGROUPS IN CLINICAL PRACTICE. EXPERIENCE OF PULMONOLOGISTS AND RHEUMATOLOGISTS
Authors: P. Pérez-García, M. Retuerto-Guerrero, Y. Chuquimia, L. Sierra Herránz, J. Loarce-Martos, B. Atienza-Mateo, C. Merino Argumánez, M. Pavía Pascual, B. Miguel Ibáñez, J. Ordas Martínez, P. Baenas González, C. Sieiro Santos, C. Moriano, I. González, C. Díez, I. González Fernández, C. Álvarez Castro, E. Gutierrez, E. Diez Álvarez
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Nintedanib (NINTE) has been approved for the treatment of idiopathic pulmonary fibrosis (IPF), fibrosing intersticial lung disease (ILD) associated with autoimmune disease (AD-ILD), and progressive fibrosing ILDs of any etiology. In the nintedanib trials, its efficacy was consistent across all these subgroups. <h3>Objectives:</h3> The goals of our research were to compare the efficacy and safety of NINTE between patients with AD-ILD and patients with fibrosing lung involvement without AD, in routine clinical practice. <h3>Methods:</h3> We performed a cross sectional retrospective, multicenter, case-control study. We included a total of 108 patients diagnosed with pulmonary fibrosis treated with NINTE. 67 subjects were AD-ILD cases and 41 were non-AD-ILD controls. Continuous variables were compared by Student's test or Mann Whitney's T test, and categorical variables by Chi<sup>2</sup> test or Fisher's exact test. The p value &lt;0.05 was significant. <h3>Results:</h3> Among the AD-ILDs and non-AD-ILDs group, 58% and 32% were women (<i>p=0.01</i>). The distribution of the different pulmonary and autoimmune diseases is shown in Figure 1. Age at the time of NINTE administration was 63.7 (56.4-71.2) and 72.4 (66-78.4) years, respectively (<i>p&lt;0.001</i>) (Table 1). The median time from diagnosis of ILD to onset of NINTE was 3.6 (1.6-5.9) and 2.3 (1-4) years (<i>p=0.04</i>). 24 patients had a history of occupational exposure (9% and 44%, <i>p&lt;0,001</i>) (Table 1). The presence of emphysema on baseline thoracic high resolution computed tomography (HRCT) was more frequent in the control group (<i>p= 0.03</i>), whereas ground glass was more frequent in cases (<i>p=0.02</i>). Honeycombing and reticulation patterns were similar in both groups. Patients with AD-ILD had higher ESR (<i>p&lt;0.001</i>) and CRP (<i>p&lt;0.001</i>) levels before the initiation of NINTE. At the time of starting NINTE, mean FVC% predicted were 71.9 and 75.1; and mean DLCO% predicted were 45.8 and 41.4, respectively. Pulmonary function test remained stable across the first 12 months in AD-ILD and non-AD-ILD (FVC% 71.0 and 80%; DLCO% 47 and 37.9), Available thoracic HRCT images improved/stabilized in 74% and 78% of patients in the case and control groups, respectively. In both groups, adverse events, acute exacerbations of ILD and discontinuation rate were similar. During a median follow-up of 15 (8.6-29.5) months, 24 patients withdrew NINTE due to gastrointestinal adverse events and 30 subjects required a dose reduction (150 mg daily). <h3>Conclusion:</h3> Baseline clinical and radiological characteristics between AD-ILD and non-AD-ILD were different, while respiratory function tests were similar. During follow-up, FVC%, DLCO% and HRCT images stabilized in both groups. Therefore, we conclude that NINTE may be effective for both AD-ILD and non-AD-ILD, although longer follow-up time would be needed to see the real efficacy of the drug. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>