Francesco Bonella,1 Martin Kolb,2 Eric S White,3 Vincent Cottin,4 Joao de Andrade,5 Ian Glaspole,6 Benjamin Strobel,7 Janine Roy,8 Carina Ittrich,7 Claudia Diefenbach,7 Klaus B Rohr,9 Manuel Quaresma,9 Fernando J Martinez10 on behalf of the INSTAGE trial investigators
1Interstitial and Rare Lung Disease Unit, Ruhrlandklinik, University Hospital, Duisburg-Essen University, Essen, Germany; 2McMaster University and St. Joseph’s Healthcare, Hamilton, Ontario, Canada; 3University of Michigan, Division of Pulmonary and Critical Care Medicine, Ann Arbor, Michigan, USA; 4Respiratory Diseases Department, National Reference Center for Rare Pulmonary Diseases, Respiratory Diseases Department, Louis Pradel Hospital, Claude Bernard Lyon 1 University, Lyon, France; 5Vanderbilt University School of Medicine, Nashville, Tennessee, USA; 6Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, and Department of Medicine, Monash University, Melbourne, Victoria, Australia; 7Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany; 8Staburo GmbH, Munich, Germany; 9Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany; 10Weill Cornell Medicine, New York, USA
Introduction
- Nintedanib is an intracellular inhibitor of tyrosine kinases approved for the treatment of IPF. Nintedanib reduces the progression of IPF by reducing the rate of decline in forced vital capacity (FVC).1
- Sildenafil, a phosphodiesterase-5 inhibitor and pulmonary-selective vasodilator, is an approved treatment for pulmonary arterial hypertension.
- Exploratory analyses of data from the INSTAGE trial, conducted in patients with IPF and severely impaired gas exchange, suggested that treatment with nintedanib plus sildenafil was associated with a numerical reduction in FVC decline over 24 weeks compared to nintedanib alone.2