ABSTRACT
BACKGROUND: Nintedanib, an oral tyrosine kinase inhibitor, has been shown to slow down the progression of idiopathic pulmonary fibrosis (IPF) in two randomised placebo-controlled trials by reducing the annual decline in forced vital capacity (FVC). However, real-world experience is limited. OBJECTIVE: To assess the efficacy and safety of nintedanib in a large cohort of patients treated at a tertiary referral site for interstitial lung diseases. METHODS: The records of patients with a confirmed diagnosis of IPF were reviewed. Full medical history, pulmonary function, and adverse events (AEs) were recorded from each clinic visit. Disease progression was defined as a reduction in FVC ≥5% and/or in diffusing capacity of the lung for carbon monoxide ≥15% according to recent publications. Only patients with a treatment duration ≥3 months were included in the efficacy evaluation. RESULTS: A total of 64 patients were treated. Mean ± standard deviation (SD) FVC was 71 ± 21% predicted, and the mean time from diagnosis to initiation of nintedanib treatment was 23.8 months. Nearly half of patients (n = 30, 47%) had received prior pirfenidone treatment. The mean duration of follow-up was 11 months. At 6 months following initiation of nintedanib, 67% of the patients were stable. The mean ± SD change in percent predicted FVC from baseline was 0.2 ± 7.8% at 3 months, -1.3 ± 7.9% at 6 months, and -2.1 ± 9% at 9 months. Diarrhoea was the most common AE experienced by 33% of patients and was generally manageable. CONCLUSION: The results from this real-world clinical setting support findings from previously conducted clinical trials and show that nintedanib is effective for the management of IPF and is associated with disease stabilisation. Nintedanib is generally well tolerated.
Subject(s)
Antineoplastic Agents/therapeutic use , Idiopathic Pulmonary Fibrosis/drug therapy , Indoles/therapeutic use , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies , Tertiary Care CentersABSTRACT
Mental disorders in the elderly often influence their social and physical wellbeing. Depression and anxiety disorders may frequently be found in elderly patients with chronic diseases; however, we now know that this patient group may benefit from psychotherapy. The psychotherapeutic group "40 plus" provides a supportive group intervention for physically and psychically impaired patients in their second half of life. The group intervention allows them to recognize and to activate their resources, as well as the interaction between physical disorders and psychosocial burdens and possible influential aspects to be perceived. An evaluation of 64 patients who participated in this group intervention showed a significant improvement of depression, psychosocial burdens and somatization. The concept of the group "40 plus" presented here may therefore be seen as to effectively bridge a gap in the health care of the elderly.
