Nintedanib

Nintedanib is the latest drug to have been licensed and approved by NICE for the treatment of Idiopathic Pulmonary Fibrosis (IPF).

Nintedanib works differently to pirfenidone and therefore has different side effects.

Who is eligible for nintedanib?

Nintedanib is licensed for the treatment of mild to moderate IPF, and NICE have laid down certain criteria for physicians to prescribe nintedanib within the NHS.

The lung function criteria for obtaining nintedanib is the same as that of pirfenidone with a Forced Vital Capacity (FVC) of between 50-80% predicted for age, height and weight. This means that your FVC must be between 50 – 80% predicted.

Efficacy

Like pirfenidone(Esbriet), nintedanib cannot cure or stop pulmonary fibrosis. However, both Nintedanib and Pirfenidone (Esbriet) have been shown in clinical trials to slow down the progression of IPF, meaning that the disease gets worse more slowly. The size of the benefit is broadly similar between the two drugs. At the current time it is not possible to say which drug is better, and it is important for patients to discuss the “pros and cons” of each drug with their healthcare provider.

Side effects

Nintedanib (Ofev) is reasonably well tolerated but does have side effects, primarily leading to diarrhea and nausea. It can also cause liver damage and patients taking Nintedanib (Ofev) will require monitoring of liver function tests. Nintedanib (Ofev) may also alter the risk of bleeding, and therefore if patients are taking anticoagulants, such as warfarin, they will need closer monitoring than usual and dose adjustments maybe required. There is also a small potential increased risk of heart -related death.

Drug Interactions

Some drugs interact with Nintedanib (Ofev) in the body. These include some antibiotics such as Ketaconazole and Erythromycin and other drugs such as Rifampicin, carbamazepine, phenytoin, and St. John’s wort as well as cigarette exposure. If you are concerned about any drug you are taking, please contact your healthcare practitioner for advice.

Summary

Nintedanib (Ofev) is a new anti-fibrotic drug that slows down the progression of Idiopathic Pulmonary Fibrosis. It has similarities and differences in comparison with Pirfenidone (Esbriet) so patients should discuss the options with their healthcare provider.