Nintedanib Treatment for Idiopathic Pulmonary Fibrosis Patients Who Have Been Switched from Pirfenidone Therapy: A Retrospective Case Series Study

• Main Authors: Andrea Vianello, Francesco Salton, Beatrice Molena, Cristian Turato, Maria Laura Graziani, Fausto Braccioni, Valeria Frassani, Dino Sella, Paolo Pretto, Luciana Paladini, Andi Sukthi, Marco Confalonieri
• Format: Article
• Language: English
• Published: MDPI AG 2020-02-01
• Series: Journal of Clinical Medicine
• Subjects: idiopathic pulmonary fibrosis; pirfenidone; nintedanib; adverse event; forced vital capacity
• Online Access: https://www.mdpi.com/2077-0383/9/2/422

Background: The efficacy and effectiveness of nintedanib as a first-line therapy in idiopathic pulmonary fibrosis (IPF) patients have been demonstrated by clinical trials and real-life studies. Our aim was to examine the safety profile and effectiveness of nintedanib when it is utilized as a second-line treatment in subjects who have discontinued pirfenidone. Methods: The medical charts of 12 patients who were switched from pirfenidone to nintedanib were examined retrospectively. The drug&#8217;s safety was defined by the number of adverse events (AEs) that were reported; disease progression was evaluated based on the patient&#8217;s vital status and changes in forced vital capacity (FVC) at 12-month follow-up. Results: The numbers of patients experiencing AEs and of the AEs per patient in our study group didn&#8217;t significantly differ with respect to a group of 56 individuals who were taking nintedanib as a first-line therapy during the study period (5/12 vs. 22/56; <i>p</i> = 0.9999, and 0.00 (0.00&#8722;1.00) vs. 0.00 (0.00&#8722;3.00); <i>p</i> = 0.517, respectively). Two out of the 3 patients who had been switched to nintedanib due to a rapid disease progression showed stabilized FVC values. Conclusions: Nintedanib was found to have an acceptable safety profile in the majority of the IPF patients switched from pirfenidone. Prospective studies are warranted to determine if the drug can effectively delay disease progression in these patients.