Nintedanib is an intracellular tyrosine kinase inhibitor approved in a treatment of idiopathic pulmonary fibrosis. It reduces the annual rate of forced vital capacity decline by approximately 50%, that results in slowing of disease progression. The drug also reduces the incidence of acute exacerbations of idiopathic pulmonary fibrosis. The efficacy of nintedanib was the same in different groups of patients, irrespectively to disease status, age, gender and race. The most frequent side effects were gastrointestinal, i.e. diarrhea and nausea. If they occur symptomatic treatment should be implemented. In case of persistent symptoms despite of this, nintedanib dose should be decreased or drug interrupted. The research on combination therapy with pirfenidone did not show the new adverse drug reactions, there were no changes in pharmacokinetics of both drugs. A trend to improve the efficacy of the combination therapy in comparison to monotherapy with both drugs was noted, but further research in this field is needed. There are also trials of nintedanib in the treatment of other fibrosing interstitial lung diseases, i.e. chronic hypersensitivity pneumonitis, stage IV sarcoidosis or connective tissue disease related lung disorders.
Keywords: combined therapy; fibrosing interstitial lung disease; idiopathic pulmonary fibrosis; nintedanib.
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