Comprehensive Evaluation of Effectiveness of Nintedanib in the Management of Non-idiopathic Pulmonary Fibrosis : Systematic Review and Meta-analysis

Abstract

Introduction:

Nintedanib, an intracellular tyrosine kinase inhibitor, has demonstrated potential in inhibiting the progression of lung fibrosis based on preclinical data. Non-Idiopathic pulmonary fibrosis (non-IPF) is caused by a group of diseases with known origin. The aim of this systematic review and meta-analysis was to determine the effectiveness of nintedanib in the management of non-IPF.

Methods:

We gathered studies through the use of databases like Springer, PubMed,Sage journals, Elsevier, ERS publications .IBM SPSS Statistics version 29  was used to evaluate the quality of the studies . It was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The certainty of the evidence was assessed using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach.

Results:

We accumulated 5 studies comprising a total of 6,377 participants (3,187 composed of nintedanib group and the remaining 3190 were the control/comparison group). The results were calculated based on 2 major outcomes. The first outcome was change in FVC percentage from baseline to 12 months which was evaluated using 2 studies. The results observed were a mean of 75.9 %for Baseline FVC and 83.3% at the end of 12 months which clearly showed improvement in the FVC percent for the nintedanib group.  The second outcome assessed was rate of decline of FVC in  ml/year for 3 studies. The mean reduction rate recorded in the nintedanib group was -93.84 mL/year, which was significantly lower than the corresponding reduction rate of -173.55mL/year reported in the placebo/control group. These differences highlight that nintedanib may slow the progression of non-IPF pulmonary fibrosis.

Conclusion:

Ninetedanib appears to diminish the decline in pulmonary function in various forms of non-IPF and future recommendations should consider Nintedanib for non-IPF. Larger controlled studies in non-IPF are required to be confident about any general effect on mortality by antifibrotic therapy.

Keywords: Non-idiopathic pulmonary fibrosis, Meta-Analysis, Ninetedanib, FVC Rate of decline, FVC percent