Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

Giles Dixon; Samuel Hague; Sarah Mulholland; Huzaifa Adamali; Aye Myat Noe Khin; Hannah Thould; Roisin Connon; Paul Minnis; Eoin Murtagh; Fasihul Khan; Sameen Toor; Alexandra Lawrence; Marium Naqvi; Alex West; Robina K. Coker; Katie Ward; Leda Yazbeck; Simon Hart; Theresa Garfoot; Kate Newman; Pilar Rivera-Ortega; Lachlan Stranks; Paul Beirne; Jessica Bradley; Catherine Rowan; Sarah Agnew; Mahin Ahmad; Lisa G. Spencer; Joshua Aigbirior; Ahmed Fahim; Andrew M. Wilson; Elizabeth Butcher; Sy Giin Chong; Gauri Saini; Sabrina Zulfikar; Felix Chua; Peter M. George; Maria Kokosi; Vasileios Kouranos; Philip Molyneaux; Elisabetta Renzoni; Benedetta Vitri; Athol U. Wells; Lisa M. Nicol; Stephen Bianchi; Raman Kular; Huajian Liu; Alexander John; Sarah Barth; Melissa Wickremasinghe; Ian A. Forrest; Ian Grimes; A. John Simpson; Sophie V. Fletcher; Mark G. Jones; Emma Kinsella; Jennifer Naftel; Nicola Wood; Jodie Chalmers; Anjali Crawshaw; Louise E. Crowley; Davinder Dosanjh; Christopher C. Huntley; Gareth I. Walters; Timothy Gatheral; Catherine Plum; Shiva Bikmalla; Raja Muthusami; Helen Stone; Jonathan C.L. Rodrigues; Krasimira Tsaneva-Atanasova; Chris J. Scotton; Michael A. Gibbons; Shaney L. Barratt

doi:10.1183/23120541.00529-2023

Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

Giles Dixon, Samuel Hague, Sarah Mulholland, Huzaifa Adamali, Aye Myat Noe Khin, Hannah Thould, Roisin Connon, Paul Minnis, Eoin Murtagh, Fasihul Khan, Sameen Toor, Alexandra Lawrence, Marium Naqvi, Alex West, Robina K. Coker, Katie Ward, Leda Yazbeck, Simon Hart, Theresa Garfoot, Kate NewmanPilar Rivera-Ortega, Lachlan Stranks, Paul Beirne, Jessica Bradley, Catherine Rowan, Sarah Agnew, Mahin Ahmad, Lisa G. Spencer, Joshua Aigbirior, Ahmed Fahim, Andrew M. Wilson, Elizabeth Butcher, Sy Giin Chong, Gauri Saini, Sabrina Zulfikar, Felix Chua, Peter M. George, Maria Kokosi, Vasileios Kouranos, Philip Molyneaux, Elisabetta Renzoni, Benedetta Vitri, Athol U. Wells, Lisa M. Nicol, Stephen Bianchi, Raman Kular, Huajian Liu, Alexander John, Sarah Barth, Melissa Wickremasinghe, Ian A. Forrest, Ian Grimes, A. John Simpson, Sophie V. Fletcher, Mark G. Jones, Emma Kinsella, Jennifer Naftel, Nicola Wood, Jodie Chalmers, Anjali Crawshaw, Louise E. Crowley, Davinder Dosanjh, Christopher C. Huntley, Gareth I. Walters, Timothy Gatheral, Catherine Plum, Shiva Bikmalla, Raja Muthusami, Helen Stone, Jonathan C.L. Rodrigues, Krasimira Tsaneva-Atanasova, Chris J. Scotton, Michael A. Gibbons, Shaney L. Barratt

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Abstract

Background Nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting. Methods 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey. Results 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/ modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD. Conclusion We have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting.

Original language	English
Article number	00529-2023
Journal	ERJ Open Research
Volume	10
Issue number	1
DOIs	https://doi.org/10.1183/23120541.00529-2023
State	Published - 1 Jan 2024
Externally published	Yes

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10.1183/23120541.00529-2023

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Dixon, G., Hague, S., Mulholland, S., Adamali, H., Khin, A. M. N., Thould, H., Connon, R., Minnis, P., Murtagh, E., Khan, F., Toor, S., Lawrence, A., Naqvi, M., West, A., Coker, R. K., Ward, K., Yazbeck, L., Hart, S., Garfoot, T., ... Barratt, S. L. (2024). Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK. ERJ Open Research, 10(1), Article 00529-2023. https://doi.org/10.1183/23120541.00529-2023

@article{d00feedd1ce644119a0544d6711f4a71,

title = "Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK",

abstract = "Background Nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting. Methods 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey. Results 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/ modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD. Conclusion We have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting.",

author = "Giles Dixon and Samuel Hague and Sarah Mulholland and Huzaifa Adamali and Khin, {Aye Myat Noe} and Hannah Thould and Roisin Connon and Paul Minnis and Eoin Murtagh and Fasihul Khan and Sameen Toor and Alexandra Lawrence and Marium Naqvi and Alex West and Coker, {Robina K.} and Katie Ward and Leda Yazbeck and Simon Hart and Theresa Garfoot and Kate Newman and Pilar Rivera-Ortega and Lachlan Stranks and Paul Beirne and Jessica Bradley and Catherine Rowan and Sarah Agnew and Mahin Ahmad and Spencer, {Lisa G.} and Joshua Aigbirior and Ahmed Fahim and Wilson, {Andrew M.} and Elizabeth Butcher and Chong, {Sy Giin} and Gauri Saini and Sabrina Zulfikar and Felix Chua and George, {Peter M.} and Maria Kokosi and Vasileios Kouranos and Philip Molyneaux and Elisabetta Renzoni and Benedetta Vitri and Wells, {Athol U.} and Nicol, {Lisa M.} and Stephen Bianchi and Raman Kular and Huajian Liu and Alexander John and Sarah Barth and Melissa Wickremasinghe and Forrest, {Ian A.} and Ian Grimes and Simpson, {A. John} and Fletcher, {Sophie V.} and Jones, {Mark G.} and Emma Kinsella and Jennifer Naftel and Nicola Wood and Jodie Chalmers and Anjali Crawshaw and Crowley, {Louise E.} and Davinder Dosanjh and Huntley, {Christopher C.} and Walters, {Gareth I.} and Timothy Gatheral and Catherine Plum and Shiva Bikmalla and Raja Muthusami and Helen Stone and Rodrigues, {Jonathan C.L.} and Krasimira Tsaneva-Atanasova and Scotton, {Chris J.} and Gibbons, {Michael A.} and Barratt, {Shaney L.}",

note = "Publisher Copyright: {\textcopyright} The authors 2024.",

year = "2024",

month = jan,

day = "1",

doi = "10.1183/23120541.00529-2023",

language = "English",

volume = "10",

journal = "ERJ Open Research",

issn = "2312-0541",

publisher = "European Respiratory Society",

number = "1",

}

Dixon, G, Hague, S, Mulholland, S, Adamali, H, Khin, AMN, Thould, H, Connon, R, Minnis, P, Murtagh, E, Khan, F, Toor, S, Lawrence, A, Naqvi, M, West, A, Coker, RK, Ward, K, Yazbeck, L, Hart, S, Garfoot, T, Newman, K, Rivera-Ortega, P, Stranks, L, Beirne, P, Bradley, J, Rowan, C, Agnew, S, Ahmad, M, Spencer, LG, Aigbirior, J, Fahim, A, Wilson, AM, Butcher, E, Chong, SG, Saini, G, Zulfikar, S, Chua, F, George, PM, Kokosi, M, Kouranos, V, Molyneaux, P, Renzoni, E, Vitri, B, Wells, AU, Nicol, LM, Bianchi, S, Kular, R, Liu, H, John, A, Barth, S, Wickremasinghe, M, Forrest, IA, Grimes, I, Simpson, AJ, Fletcher, SV, Jones, MG, Kinsella, E, Naftel, J, Wood, N, Chalmers, J, Crawshaw, A, Crowley, LE, Dosanjh, D, Huntley, CC, Walters, GI, Gatheral, T, Plum, C, Bikmalla, S, Muthusami, R, Stone, H, Rodrigues, JCL, Tsaneva-Atanasova, K, Scotton, CJ, Gibbons, MA & Barratt, SL 2024, 'Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK', ERJ Open Research, vol. 10, no. 1, 00529-2023. https://doi.org/10.1183/23120541.00529-2023

TY - JOUR

T1 - Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

AU - Dixon, Giles

AU - Hague, Samuel

AU - Mulholland, Sarah

AU - Adamali, Huzaifa

AU - Khin, Aye Myat Noe

AU - Thould, Hannah

AU - Connon, Roisin

AU - Minnis, Paul

AU - Murtagh, Eoin

AU - Khan, Fasihul

AU - Toor, Sameen

AU - Lawrence, Alexandra

AU - Naqvi, Marium

AU - West, Alex

AU - Coker, Robina K.

AU - Ward, Katie

AU - Yazbeck, Leda

AU - Hart, Simon

AU - Garfoot, Theresa

AU - Newman, Kate

AU - Rivera-Ortega, Pilar

AU - Stranks, Lachlan

AU - Beirne, Paul

AU - Bradley, Jessica

AU - Rowan, Catherine

AU - Agnew, Sarah

AU - Ahmad, Mahin

AU - Spencer, Lisa G.

AU - Aigbirior, Joshua

AU - Fahim, Ahmed

AU - Wilson, Andrew M.

AU - Butcher, Elizabeth

AU - Chong, Sy Giin

AU - Saini, Gauri

AU - Zulfikar, Sabrina

AU - Chua, Felix

AU - George, Peter M.

AU - Kokosi, Maria

AU - Kouranos, Vasileios

AU - Molyneaux, Philip

AU - Renzoni, Elisabetta

AU - Vitri, Benedetta

AU - Wells, Athol U.

AU - Nicol, Lisa M.

AU - Bianchi, Stephen

AU - Kular, Raman

AU - Liu, Huajian

AU - John, Alexander

AU - Barth, Sarah

AU - Wickremasinghe, Melissa

AU - Forrest, Ian A.

AU - Grimes, Ian

AU - Simpson, A. John

AU - Fletcher, Sophie V.

AU - Jones, Mark G.

AU - Kinsella, Emma

AU - Naftel, Jennifer

AU - Wood, Nicola

AU - Chalmers, Jodie

AU - Crawshaw, Anjali

AU - Crowley, Louise E.

AU - Dosanjh, Davinder

AU - Huntley, Christopher C.

AU - Walters, Gareth I.

AU - Gatheral, Timothy

AU - Plum, Catherine

AU - Bikmalla, Shiva

AU - Muthusami, Raja

AU - Stone, Helen

AU - Rodrigues, Jonathan C.L.

AU - Tsaneva-Atanasova, Krasimira

AU - Scotton, Chris J.

AU - Gibbons, Michael A.

AU - Barratt, Shaney L.

PY - 2024/1/1

Y1 - 2024/1/1

N2 - Background Nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting. Methods 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey. Results 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/ modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD. Conclusion We have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting.

AB - Background Nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting. Methods 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey. Results 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/ modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD. Conclusion We have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting.

UR - http://www.scopus.com/inward/record.url?scp=85183625414&partnerID=8YFLogxK

U2 - 10.1183/23120541.00529-2023

DO - 10.1183/23120541.00529-2023

M3 - Article

AN - SCOPUS:85183625414

SN - 2312-0541

VL - 10

JO - ERJ Open Research

JF - ERJ Open Research

IS - 1

M1 - 00529-2023

ER -

Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

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