# Prognostic factors in patients with interstitial lung disease treated with nintedanib: a multicenter retrospective study in Japan

## TL;DR

This study examines factors affecting survival in patients with lung diseases treated with nintedanib, finding that age, oxygen levels, and BMI are key predictors of outcomes.

## Contribution

The study identifies specific prognostic factors for patients with IPF and PF-ILD treated with nintedanib in a Japanese multicenter cohort.

## Key findings

- Patients with IPF and PF-ILD had similar survival outcomes after nintedanib treatment.
- Older age, low oxygen saturation, and low BMI were associated with shorter survival.
- Lower BMI was linked to faster decline in lung function.

## Abstract

Nintedanib is widely used to slow disease progression and prevent acute exacerbations in patients with idiopathic pulmonary fibrosis (IPF) and progressive fibrosing interstitial lung disease (PF-ILD). We retrospectively analysed patients who initiated nintedanib for IPF or PF-ILD between August 2019 and July 2023 across 15 institutions in Japan, focusing on prognosis and disease progression. Patients were divided into two groups based on whether they survived for ≥ 3 years after nintedanib initiation, and their characteristics were compared. We also evaluated factors associated with annual forced vital capacity (FVC) decline and acute exacerbations. A total of 413 patients (171 with IPF and 242 with PF-ILD) were included. Median survival was 1,177 days for IPF and 1,268 days for PF-ILD, with no significant difference (P = 0.20). Patients surviving < 3 years were older (75.0 vs. 71.0 years), more frequently had resting arterial oxygen saturation (SpO2) < 95% (44.5% vs. 18.0%), and lower body mass index (BMI) (21.9 vs. 24.1 kg/m2). Additionally, patients with a BMI < 22 kg/m2 showed greater annual relative FVC decline. In conclusion, patients with IPF and PF-ILD showed comparable outcomes following nintedanib treatment. Age ≥ 65 years, resting SpO2 < 95%, and BMI < 22 kg/m2 were associated with shorter survival after nintedanib initiation.

The online version contains supplementary material available at 10.1038/s41598-025-34071-7.