University of Michigan Health System, Ann Arbor, MI, USA.
McMaster University, Hamilton, ON, Canada.
Eur Respir J. 2018 Aug 2;52(2). doi: 10.1183/13993003.02593-2017. Print 2018 Aug.
In the Phase III INPULSIS® trials, nintedanib reduced the annual rate of decline in forced vital capacity (FVC) placebo in patients with idiopathic pulmonary fibrosis (IPF).We conducted analyses of the distribution of changes in FVC in the INPULSIS® trials and FVC changes in the open-label extension trial INPULSIS®-ON in subgroups of patients based on whether patients had shown an improvement or no decline in FVC in INPULSIS®. Analyses were descriptive.Based on the annual rate of change in FVC, 158 of 638 patients (24.8%) treated with nintedanib and 38 of 423 patients (9.0%) treated with placebo had an improvement/no decline in FVC in the INPULSIS® trials. In patients whose FVC improved/did not decline, median (interquartile range) improvements in FVC at week 52 were 76.5 (31-152) mL and 57.5 (31-103) mL in the nintedanib and placebo groups, respectively. Changes in FVC from baseline to week 48 of INPULSIS®-ON were similar in patients whose FVC improved or declined in the preceding INPULSIS® trial.In the INPULSIS® trials, treatment with nintedanib resulted in a greater proportion of patients with IPF showing an improvement/no decline in FVC compared to taking placebo. Mechanisms underlying improvement in FVC in patients with IPF are unknown.
在 III 期 INPULSIS®试验中,尼达尼布减少了特发性肺纤维化(IPF)患者用力肺活量(FVC)的年下降率——安慰剂。我们对 INPULSIS®试验中 FVC 的变化分布进行了分析,并根据 INPULSIS®试验中 FVC 是否改善或无下降,对接受尼达尼布和安慰剂治疗的患者亚组的 FVC 变化进行了开放性扩展试验 INPULSIS®-ON 的分析。分析是描述性的。根据 FVC 的年变化率,638 名接受尼达尼布治疗的患者中有 158 名(24.8%)和 423 名接受安慰剂治疗的患者中有 38 名(9.0%)FVC 在 INPULSIS®试验中得到改善/无下降。在 FVC 改善/未下降的患者中,尼达尼布组和安慰剂组第 52 周 FVC 的中位数(四分位距)改善分别为 76.5(31-152)mL 和 57.5(31-103)mL。在 INPULSIS®-ON 中,从基线到第 48 周 FVC 的变化在 INPULSIS®试验中 FVC 改善或下降的患者中相似。在 INPULSIS®试验中,与安慰剂相比,尼达尼布治疗导致更多的 IPF 患者 FVC 得到改善/无下降。IPF 患者 FVC 改善的机制尚不清楚。