Imperial College London
Alternate

PROFESSOR DAVID HANSELL

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor of Thoracic Imaging
 
 
 
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Contact

 

d.m.hansell Website

 
 
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Location

 

RadiologySouth BlockRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Raghu:2016:10.1164/rccm.201602-0402OC,
author = {Raghu, G and Wells, AU and Nicholson, AG and Richeldi, L and Flaherty, KR and Le, Maulf F and Stowasser, S and Schlenker-Herceg, R and Hansell, DM},
doi = {10.1164/rccm.201602-0402OC},
journal = {American Journal of Respiratory and Critical Care Medicine},
pages = {78--85},
title = {Effect of nintedanib in subgroups of idiopathic pulmonary fibrosis by diagnostic criteria},
url = {http://dx.doi.org/10.1164/rccm.201602-0402OC},
volume = {195},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - RATIONALE: In the absence of a surgical lung biopsy, patients diagnosed with idiopathic pulmonary fibrosis (IPF) in clinical practice could participate in the INPULSIS® trials of nintedanib if they had honeycombing and/or traction bronchiectasis plus reticulation, without atypical features of usual interstitial pneumonia (UIP), on high-resolution computed tomography (HRCT). Thus the patients in these trials represented patients with definite UIP and a large subgroup of patients with possible UIP. OBJECTIVE: We investigated the potential impact of diagnostic subgroups on the progression of IPF and effect of nintedanib. METHODS: Post-hoc subgroup analysis of patients with honeycombing on HRCT and/or confirmation of UIP by biopsy versus patients without either, using pooled data from the INPULSIS® trials. MEASUREMENTS AND MAIN RESULTS: 723 (68.1%) patients had honeycombing and/or biopsy and 338 (31.9%) had no honeycombing or biopsy. In these subgroups, respectively, the adjusted annual rate of decline in forced vital capacity (FVC) in patients treated with placebo was -225.7 mL/year and -221.0 mL/year, and the nintedanib versus placebo difference in adjusted annual rate of decline in FVC was 117.0 mL/year (95% CI: 76.3, 157.8) and 98.9 mL/year (95% CI: 36.4, 161.5). There was no significant treatment-by-subgroup interaction (p=0.8139). Adverse events were similar between subgroups. CONCLUSION: Patients with IPF diagnosed in clinical practice who have possible UIP with traction bronchiectasis on HRCT and have not undergone surgical lung biopsy have disease that progresses in a similar way, and responds similarly to nintedanib, as patients with honeycombing on HRCT and/or confirmation of UIP by biopsy. Clinical trial registration available at www.clinicaltrials.gov, IDs NCT01335464 and NCT01335477.
AU  - Raghu,G
AU  - Wells,AU
AU  - Nicholson,AG
AU  - Richeldi,L
AU  - Flaherty,KR
AU  - Le,Maulf F
AU  - Stowasser,S
AU  - Schlenker-Herceg,R
AU  - Hansell,DM
DO  - 10.1164/rccm.201602-0402OC
EP  - 85
PY  - 2016///
SN  - 1535-4970
SP  - 78
TI  - Effect of nintedanib in subgroups of idiopathic pulmonary fibrosis by diagnostic criteria
T2  - American Journal of Respiratory and Critical Care Medicine
UR  - http://dx.doi.org/10.1164/rccm.201602-0402OC
UR  - http://hdl.handle.net/10044/1/39737
VL  - 195
ER  -
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