Low-dose vs standard-dose nintedanib at initiation in fibrosing interstitial lung disease: a target-trial emulation of treatment persistence and lung function.
Ann Am Thorac SocSep 1, 2026
Clinical ResearchPulmonology
Shota Kaburaki, Toru Tanaka, Koichiro Kamio et al.
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In 30 seconds
This observational study emulated a randomized trial to compare the effects of initiating nintedanib at 100 mg vs 150 mg twice daily in 172 patients with fibrosing interstitial lung disease. The study found that starting at 100 mg improved treatment persistence over 12 months, extending the restricted mean time on treatment by 52.9 days (95% CI, 11.8-97.1 days) and reducing the discontinuation risk.
Key findings
- Starting nintedanib at 100 mg extended the 12-month RMST by 52.9 days.
- The 12-month treatment discontinuation risk was lower at 100 mg (0.135) compared to 150 mg (0.281).
- The change in forced vital capacity % predicted was similar among survivors, but estimates were imprecise.
Why it matters
Understanding the impact of dosing strategies on treatment persistence is crucial for managing fibrosing interstitial lung disease, as early intolerance can lead to treatment discontinuation and worsen patient outcomes.