Nintedanib for treating idiopathic pulmonary fibrosis when forced vital capacity is above 80% predicted

Nintedanib is recommended as an option for treating idiopathic pulmonary fibrosis in adults, only if:

• they have a forced vital capacity of above 80% predicted
• the company provides it according to the commercial arrangement

Notes:

• NICE note that "..the technology appraisal is for treating idiopathic pulmonary fibrosis in people with a forced vital capacity (FVC) above 80% predicted. Nintedanib is also recommended for people with an FVC between 50% and 80% predicted..Currently, the only option for people with idiopathic pulmonary fibrosis with an FVC above 80% predicted is best supportive care.."
• Nintedanib is a tyrosine kinase inhibitor which displays anti-angiogenesis properties through blockade of the vascular endothelial growth factor (VEGF) pathway
• been shown to significantly reduce the progression of idiopathic pulmonary fibrosis (2)
  • gastrointestinal events, mainly diarrhoea, are the main adverse events caused by the treatment
  • studies suggest that nintedanib stabilizes lung function till lung transplantation, with no increased surgical complications or postoperative mortality after lung transplantation

Reference:

1. NICE (February 2023). Nintedanib for treating idiopathic pulmonary fibrosis when forced vital capacity is above 80% predicted
2. Rivera-Ortega P, Hayton C, Blaikley J, Leonard C, Chaudhuri N. Nintedanib in the management of idiopathic pulmonary fibrosis: clinical trial evidence and real-world experience. Ther Adv Respir Dis. 2018 Jan-Dec;12:1753466618800618