Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Respir Investig. 2022 Nov;60(6):787-797. doi: 10.1016/j.resinv.2022.06.009. Epub 2022 Aug 1.
A previous subgroup analysis of data from the INBUILD trial showed that nintedanib reduced the annual rate of decline in forced vital capacity (FVC) in Japanese patients with progressive fibrosing interstitial lung diseases (PF-ILDs). The safety profile of nintedanib over 52 weeks in Japanese patients was similar to that of the overall population.
Using data from 108 Japanese patients with PF-ILDs who had received at least 1 dose of study medication in the INBUILD trial, we evaluated the effect of nintedanib on disease progression and assessed the safety profile over the whole trial period (i.e., a longer duration than the prior analysis) compared with placebo. ILD progression was defined as an absolute decline in FVC ≥10% predicted vs baseline.
Over the whole trial, in Japanese patients with PF-ILDs, nintedanib numerically lowered the risk of progression of ILD or death (hazard ratio [HR], 0.66; 95% confidence intervals [CI]: 0.37, 1.16), acute exacerbation of ILD or death (HR, 0.28; 95% CI: 0.09, 0.83), and death (HR, 0.41; 95% CI: 0.11, 1.51). The most common adverse event over the whole trial in nintedanib-treated Japanese patients was diarrhea, which was manageable for most patients by dose reduction and interruption. The safety profile of nintedanib in this longer duration analysis was consistent with that previously reported.
In this analysis of data from Japanese patients with PF-ILDs, nintedanib nominally reduced the risk of clinically meaningful outcomes reflecting disease progression, including death, over the whole trial, and no new safety concerns were observed.
ClinicalTrials.gov NCT02999178.
INBUILD 试验的一项亚组分析数据显示,尼达尼布可降低进行性肺纤维化间质性肺疾病(PF-ILD)日本患者的用力肺活量(FVC)年下降率。尼达尼布在日本患者中的安全性概况与总体人群相似。
我们使用 INBUILD 试验中至少接受过 1 剂研究药物的 108 例日本 PF-ILD 患者的数据,评估了尼达尼布对疾病进展的影响,并与安慰剂相比,评估了整个试验期间(即长于之前分析)的安全性概况。ILD 进展定义为 FVC 绝对值较基线下降≥10%预测值。
在整个试验中,尼达尼布可降低日本 PF-ILD 患者发生 ILD 或死亡的进展风险(风险比[HR],0.66;95%置信区间[CI]:0.37,1.16)、ILD 急性加重或死亡(HR,0.28;95% CI:0.09,0.83)和死亡(HR,0.41;95% CI:0.11,1.51)的风险。尼达尼布治疗的日本患者中整个试验期间最常见的不良事件是腹泻,大多数患者通过降低剂量和中断治疗可控制。此更长时间分析中尼达尼布的安全性概况与之前报告的一致。
在这项日本 PF-ILD 患者的数据分析中,尼达尼布可降低整个试验中反映疾病进展(包括死亡)的有临床意义结局的风险,且未观察到新的安全性问题。
ClinicalTrials.gov NCT02999178。