Improvement in Patient-Reported Outcomes and Forced Vital Capacity during Nintedanib Treatment of Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a progressive and incurable disease with limited overall survival. Nintedanib is a multikinase inhibitor, and its efficacy on IPF was demonstrated in phase III trials. However, a discrepancy exists between forced vital capacity (FVC) and patient-reported outcomes during nintedanib treatment. Accordingly, we retrospectively analyzed the effects of nintedanib on FVC and patient-reported outcomes among 25 IPF patients. Patient-reported outcomes were evaluated with modified medical research council (mMRC) grade and COPD assessment test (CAT) score. The changes in mMRC grade, CAT score, and FVC data were obtained 6 months before, at the time of, and 6 and 12 months after nintedanib introduction. Significant difference in the mMRC grade was observed only between the baseline and 6 months after treatment (improvement: p = 0.0429). By contrast, there were significant deterioration (p < 0.001) in the CAT scores between 6 months before and the baseline and significant improvement (p < 0.001) between the baseline and 6 months or 12 months after treatment. Overall, 14 patients were judged as efficient with CAT scores after 6-month treatment. Among these 14 patients, only 4 patients (28.6%) were also judged as efficient with mMRC grade. Thus, the CAT score could be more useful in the subjective assessment of IPF. Moreover, FVC was improved 6 months after nintedanib introduction in 12 out of 24 patients with the complete set of the relevant data. These results indicate that nintedanib exhibits favorable effects in IPF from both subjective and objective evaluations.