Therapeutic effect of nintedanib on acute exacerbation of interstitial lung diseases

Ito, Yoko; Tazaki, Gen; Kondo, Yusuke; Takahashi, Genki; Sakamaki, Fumio

doi:10.1016/j.rmcr.2019.02.021

Cited by 13 publications

(14 citation statements)

References 14 publications

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“…Usually, corticosteroid therapy is empirically used, with or without immunosuppressive agents and antibiotics. [205][206][207][208][209][210][211][213][214][215].…”

Section: Acute Exacerbation Of Ra-ildmentioning

confidence: 99%

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Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Lights and Shadows

Cassone

Manfredi

Vacchi

et al. 2020

JCM

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Rheumatoid arthritis (RA) is a chronic and systemic inflammatory disease affecting 0.5–1% of the population worldwide. Interstitial lung disease (ILD) is a serious pulmonary complication of RA and it is responsible for 10–20% of mortality, with a mean survival of 5–8 years. However, nowadays there are no therapeutic recommendations for the treatment of RA-ILD. Therapeutic options for RA-ILD are complicated by the possible pulmonary toxicity of many disease modifying anti-rheumatic drugs (DMARDs) and by their unclear efficacy on pulmonary disease. Therefore, joint and lung involvement should be evaluated independently of each other for treatment purposes. On the other hand, some similarities between RA-ILD and idiopathic pulmonary fibrosis and the results of the recent INBIULD trial suggest a possible future role for antifibrotic agents. From this perspective, we review the current literature describing the pulmonary effects of drugs (immunosuppressants, conventional, biological and target synthetic DMARDs and antifibrotic agents) in patients with RA and ILD. In addition, we suggest a framework for the management of RA-ILD patients and outline a research agenda to fill the gaps in knowledge about this challenging patient cohort.

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“…Usually, corticosteroid therapy is empirically used, with or without immunosuppressive agents and antibiotics. [205][206][207][208][209][210][211][213][214][215].…”

Section: Acute Exacerbation Of Ra-ildmentioning

confidence: 99%

“…Finally, two patients with AE successfully treated with nintedanib without corticosteroids or immunosuppressants have been described [215,216].…”

Section: Acute Exacerbation Of Ra-ildmentioning

confidence: 99%

Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Lights and Shadows

Cassone

Manfredi

Vacchi

et al. 2020

JCM

View full text Add to dashboard Cite

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“…Other studies also identified a positive effect of a treatment with RTX with plasma exchange and intravenous immunoglobulin, polymyxin B-immobilized fiber column perfusion in patients diagnosed with IPF and intravenous thrombomodulin in CTD patients [159,164]. Recently, the effective use of Nintedanib in AE in IPF patients has been described in two patients [165,166], and, of note, in INPULSIS-2 trial there was a significant difference between the nintedanib and placebo groups in the time to the first acute exacerbation (hazard ratio, 0.38; 95% CI, 0.19 to 0.77; p = 0.005), even if the reliability of this result is still controversial [167,168].…”

Section: Pharmacological Treatmentmentioning

confidence: 93%

Therapeutic Options for the Treatment of Interstitial Lung Disease Related to Connective Tissue Diseases. A Narrative Review

Vacchi

Sebastiani

Cassone

et al. 2020

JCM

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Interstitial lung disease (ILD) is one of the most serious pulmonary complications of connective tissue diseases (CTDs) and it is characterized by a deep impact on morbidity and mortality. Due to the poor knowledge of CTD-ILD’s natural history and due to the difficulties related to design of randomized control trials, there is a lack of prospective data about the prevalence, follow-up, and therapeutic efficacy. For these reasons, the choice of therapy for CTD-ILD is currently very challenging and still largely based on experts’ opinion. Treatment is often based on steroids and conventional immunosuppressive drugs, but the recent publication of the encouraging results of the INBUILD trial has highlighted a possible effective and safe use of antifibrotic drugs as a new therapeutic option for these subjects. Aim of this review is to summarize the available data and recent advances about therapeutic strategies for ILD in the context of various CTD, such as systemic sclerosis, idiopathic inflammatory myopathy and Sjogren syndrome, systemic lupus erythematosus, mixed connective tissue disease and undifferentiated connective tissue disease, and interstitial pneumonia with autoimmune features, focusing also on ongoing clinical trials.

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“…In two case studies an improvement in FVC was observed after initiation of nintedanib following an acute exacerbation [114,115]. There is a lack of real-world data on post-exacerbation survival in patients treated with nintedanib or pirfenidone.…”

Section: Use Of Nintedanib In Real-world Clinical Practicementioning

confidence: 99%

Ongoing challenges in pulmonary fibrosis and insights from the nintedanib clinical programme

et al. 2020

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The approvals of nintedanib and pirfenidone changed the treatment paradigm in idiopathic pulmonary fibrosis (IPF), and increased our understanding of the underlying disease mechanisms. Nonetheless, many challenges and unmet needs remain in the management of patients with IPF and other progressive fibrosing interstitial lung diseases. This review describes how the nintedanib clinical programme has helped to address some of these challenges. Data from this programme have informed changes to the IPF diagnostic guidelines, the timing of treatment initiation, and the assessment of disease progression. The use of nintedanib to treat patients with advanced lung function impairment, concomitant emphysema, patients awaiting lung transplantation and patients with IPF and lung cancer is discussed. The long-term use of nintedanib and an up-to-date summary of nintedanib in clinical practice are discussed. Directions for future research, namely emerging therapeutic options, precision medicine and other progressive fibrosing interstitial lung diseases, are described. Further developments in these areas should continue to improve patient outcomes.

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Therapeutic effect of nintedanib on acute exacerbation of interstitial lung diseases

Cited by 13 publications

References 14 publications

Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Lights and Shadows

Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Lights and Shadows

Therapeutic Options for the Treatment of Interstitial Lung Disease Related to Connective Tissue Diseases. A Narrative Review

Ongoing challenges in pulmonary fibrosis and insights from the nintedanib clinical programme

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