Abstract
Introduction: In the INSTAGE trial in patients with IPF and DLco ≤35% predicted, nintedanib plus sildenafil was not associated with a significant benefit on SGRQ total score (primary endpoint) vs nintedanib alone. However, nintedanib plus sildenafil was associated with stabilisation in BNP, a marker of right ventricular strain, and reduced decline in FVC vs nintedanib alone.
Aim: To assess whether baseline BNP influenced the effects of nintedanib plus sildenafil vs nintedanib alone.
Methods: In post-hoc analyses, patients with baseline BNP ≤ vs > median were compared on changes from baseline in BNP at week 24 and in SGRQ total score and FVC at weeks 12 and 24; time to absolute FVC ≥5% predicted or death; and time to relative FVC decline ≥10% predicted or death.
Results: At baseline, median BNP was 52 ng/L; 140 patients had BNP ≤52 ng/L and 133 had BNP >52 ng/L. All endpoints showed numerical benefits of nintedanib plus sildenafil vs nintedanib alone in both subgroups. Compared with patients with baseline BNP below the median, the combination provided a significantly greater benefit on BNP levels and a numerical benefit on FVC in patients with higher baseline BNP.
Conclusions: In patients with IPF and severely impaired gas exchange, the benefit of nintedanib plus sildenafil vs nintedanib alone on changes in BNP and FVC seemed more pronounced in patients with baseline BNP above the median.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2251.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019