ERJ Open Research (Jan 2024)
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
Affiliations
- Giles Dixon
- Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UK
- Samuel Hague
- Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UK
- Sarah Mulholland
- Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UK
- Huzaifa Adamali
- Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UK
- Aye Myat Noe Khin
- South West Peninsula ILD Network, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
- Hannah Thould
- South West Peninsula ILD Network, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
- Roisin Connon
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
- Paul Minnis
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
- Eoin Murtagh
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
- Fasihul Khan
- Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Sameen Toor
- Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Alexandra Lawrence
- Guy's and St Thomas’ Hospital NHS Foundation Trust, London, UK
- Marium Naqvi
- Guy's and St Thomas’ Hospital NHS Foundation Trust, London, UK
- Alex West
- Guy's and St Thomas’ Hospital NHS Foundation Trust, London, UK
- Robina K. Coker
- Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
- Katie Ward
- Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
- Leda Yazbeck
- Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
- Simon Hart
- Hull University Teaching Hospitals NHS Trust, Hull, UK
- Theresa Garfoot
- Interstitial Lung Disease Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Kate Newman
- Interstitial Lung Disease Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Pilar Rivera-Ortega
- Interstitial Lung Disease Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Lachlan Stranks
- Interstitial Lung Disease Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Paul Beirne
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Jessica Bradley
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Catherine Rowan
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Sarah Agnew
- Liverpool Interstitial Lung Disease Service, Aintree Hospital, Liverpool University Hospital NHS FT, Liverpool, UK
- Mahin Ahmad
- Liverpool Interstitial Lung Disease Service, Aintree Hospital, Liverpool University Hospital NHS FT, Liverpool, UK
- Lisa G. Spencer
- Liverpool Interstitial Lung Disease Service, Aintree Hospital, Liverpool University Hospital NHS FT, Liverpool, UK
- Joshua Aigbirior
- New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
- Ahmed Fahim
- New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
- Andrew M. Wilson
- Norfolk and Norwich University Hospital NHS Foundation Trust, UK
- Elizabeth Butcher
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Sy Giin Chong
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Gauri Saini
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Sabrina Zulfikar
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Felix Chua
- Royal Brompton and Harefield Hospitals, London, UK
- Peter M. George
- Royal Brompton and Harefield Hospitals, London, UK
- Maria Kokosi
- Royal Brompton and Harefield Hospitals, London, UK
- Vasileios Kouranos
- Royal Brompton and Harefield Hospitals, London, UK
- Philip Molyneaux
- Royal Brompton and Harefield Hospitals, London, UK
- Elisabetta Renzoni
- Royal Brompton and Harefield Hospitals, London, UK
- Benedetta Vitri
- Royal Brompton and Harefield Hospitals, London, UK
- Athol U. Wells
- Royal Brompton and Harefield Hospitals, London, UK
- Lisa M. Nicol
- Royal Infirmary of Edinburgh, Edinburgh, UK
- Stephen Bianchi
- Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
- Raman Kular
- Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
- HuaJian Liu
- Southern Health and Social Care Trust, Portadown, UK
- Alexander John
- Southern Health and Social Care Trust, Portadown, UK
- Sarah Barth
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
- Melissa Wickremasinghe
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
- Ian A. Forrest
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
- Ian Grimes
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
- A. John Simpson
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
- Sophie V. Fletcher
- University Hospital of Southampton NHS Foundation Trust, Southampton, UK
- Mark G. Jones
- University Hospital of Southampton NHS Foundation Trust, Southampton, UK
- Emma Kinsella
- University Hospital of Southampton NHS Foundation Trust, Southampton, UK
- Jennifer Naftel
- University Hospital of Southampton NHS Foundation Trust, Southampton, UK
- Nicola Wood
- University Hospital of Southampton NHS Foundation Trust, Southampton, UK
- Jodie Chalmers
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Anjali Crawshaw
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Louise E. Crowley
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Davinder Dosanjh
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Christopher C. Huntley
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Gareth I. Walters
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Timothy Gatheral
- University Hospitals of Morecambe Bay NHS Foundation Trust, Lancashire and South Cumbria ILD Service, Lancaster, UK
- Catherine Plum
- University Hospitals of Morecambe Bay NHS Foundation Trust, Lancashire and South Cumbria ILD Service, Lancaster, UK
- Shiva Bikmalla
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- Raja Muthusami
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- Helen Stone
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- Jonathan C.L. Rodrigues
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- Krasimira Tsaneva-Atanasova
- Department of Mathematics and Statistics, Faculty of Environment, Science and Economy, University of Exeter, Exeter, UK
- Chris J. Scotton
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
- Michael A. Gibbons
- South West Peninsula ILD Network, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
- Shaney L. Barratt
- Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UK
- DOI
- https://doi.org/10.1183/23120541.00529-2023
- Journal volume & issue
-
Vol. 10,
no. 1
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.
