Subgroup analysis of Asian patients in the INPULSIS® trials of nintedanib in idiopathic pulmonary fibrosis

Background and objectiveIn the two-replicate randomized Phase III INPULSIS (R) trials in patients with idiopathic pulmonary fibrosis (IPF), nintedanib 150mg bd significantly reduced the annual rate of decline in forced vital capacity (FVC) compared with placebo. The key secondary endpoints were time to first investigator-reported acute exacerbation and change from baseline in St George's Respiratory Questionnaire total score, both over 52weeks. Here, we assessed the effect of nintedanib in Asian patients. MethodsPre-specified subgroup analyses of the effect of nintedanib on the primary and key secondary endpoints in Asian versus White patients were undertaken based on pooled data from the two INPULSIS (R) trials. Safety data were analyzed descriptively. ResultsOf the treated patients, 322 were Asian (nintedanib n=194; placebo n=128) and 608 were White (nintedanib n=360; placebo n=248). In Asian patients, the nintedanib versus placebo difference in the adjusted annual rate of decline in FVC was 94.1 mL/year (95% CI: 33.7, 154.6). The treatment effect of nintedanib on the annual rate of decline in FVC in Asian and White patients was similar (treatment-by-subgroup interaction P=0.72) and consistent with the overall population. No significant treatment-by-subgroup interaction was observed for the key secondary endpoints between Asian and White patients. In Asian patients, the most common adverse event in the nintedanib group was diarrhoea (56.2% of patients vs 15.6% for placebo). ConclusionIn pre-specified subgroup analyses of Asian versus White patients with IPF in the INPULSIS (R) trials, race did not influence the effect of nintedanib on disease progression.