The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study
Background. Lung fibrosis is a sequela of COVID-19 among patients with severe pneumonia. Idiopathic pulmonary fibrosis and lung fibrosis due to COVID-19 may share many similar features. There are limited data on effects of antifibrotic treatment of infection-related lung fibrosis. This study aimed t...
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| Language: | English |
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Wiley
2022-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/9972846 |
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| author | Narongkorn Saiphoklang Pimchanok Patanayindee Pitchayapa Ruchiwit |
| author_facet | Narongkorn Saiphoklang Pimchanok Patanayindee Pitchayapa Ruchiwit |
| author_sort | Narongkorn Saiphoklang |
| collection | DOAJ |
| description | Background. Lung fibrosis is a sequela of COVID-19 among patients with severe pneumonia. Idiopathic pulmonary fibrosis and lung fibrosis due to COVID-19 may share many similar features. There are limited data on effects of antifibrotic treatment of infection-related lung fibrosis. This study aimed to evaluate the effect of nintedanib on patients’ post-COVID-19 lung fibrosis. Methods. A retrospective, matched case-control study was performed on hospitalized patients with COVID-19 pneumonia. Patients who received nintedanib treatment for COVID-19 pulmonary fibrosis (nintedanib group) were compared to patients with standard treatment (control group). The primary outcome was oxygen improvement. The secondary outcomes were chest X-ray improvement, SpO2/FiO2 ratio improvement, mortality rates at 60 days, and adverse events. Results. A total of 42 patients with COVID-19 pneumonia were included (21 in each group). Mean age was 64.43 ± 14.59 years, and 54.8% were men. At baseline, SpO2/FiO2 ratio before treatment was 200.57 ± 105.77 in the nintedanib group and 326.90 ± 137.10 in the control group (P=0.002). Oxygen improvement and chest X-ray improvement were found in 71.4% and 71.4% in the nintedanib group and in 66.7% and 66.7% in the control group (P=0.739). The nintedanib group had more improvement in SpO2/FiO2 ratio than in the control group (144.38 ± 118.05 vs 55.67 ± 75.09, P=0.006). The 60-day mortality rates of the nintedanib and the control groups were 38.1% vs 23.8%, P=0.317. Hepatitis and loss of appetite were common adverse events (9.5% and 9.5%), while the incidence of diarrhea was 4.8%. Conclusions. Nintedanib as add-on treatment in post-COVID-19 lung fibrosis did not improve oxygenation, chest X-ray findings, or the 60-day mortality. However, this antifibrotic drug improved SpO2/FiO2 ratio in our patients. Further randomized controlled trials are needed to determine the efficacy of nintedanib for treatment of patients with post-COVID-19 lung fibrosis. Trial Registration. This study was registered in TCTR20220426001. |
| format | Article |
| id | doaj-art-1254ea637973493fb1d84c1595eb4863 |
| institution | Kabale University |
| issn | 2090-1313 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-1254ea637973493fb1d84c1595eb48632025-02-03T05:57:24ZengWileyCritical Care Research and Practice2090-13132022-01-01202210.1155/2022/9972846The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational StudyNarongkorn Saiphoklang0Pimchanok Patanayindee1Pitchayapa Ruchiwit2Division of Pulmonary and Critical Care MedicineDivision of Pulmonary and Critical Care MedicineDivision of Pulmonary and Critical Care MedicineBackground. Lung fibrosis is a sequela of COVID-19 among patients with severe pneumonia. Idiopathic pulmonary fibrosis and lung fibrosis due to COVID-19 may share many similar features. There are limited data on effects of antifibrotic treatment of infection-related lung fibrosis. This study aimed to evaluate the effect of nintedanib on patients’ post-COVID-19 lung fibrosis. Methods. A retrospective, matched case-control study was performed on hospitalized patients with COVID-19 pneumonia. Patients who received nintedanib treatment for COVID-19 pulmonary fibrosis (nintedanib group) were compared to patients with standard treatment (control group). The primary outcome was oxygen improvement. The secondary outcomes were chest X-ray improvement, SpO2/FiO2 ratio improvement, mortality rates at 60 days, and adverse events. Results. A total of 42 patients with COVID-19 pneumonia were included (21 in each group). Mean age was 64.43 ± 14.59 years, and 54.8% were men. At baseline, SpO2/FiO2 ratio before treatment was 200.57 ± 105.77 in the nintedanib group and 326.90 ± 137.10 in the control group (P=0.002). Oxygen improvement and chest X-ray improvement were found in 71.4% and 71.4% in the nintedanib group and in 66.7% and 66.7% in the control group (P=0.739). The nintedanib group had more improvement in SpO2/FiO2 ratio than in the control group (144.38 ± 118.05 vs 55.67 ± 75.09, P=0.006). The 60-day mortality rates of the nintedanib and the control groups were 38.1% vs 23.8%, P=0.317. Hepatitis and loss of appetite were common adverse events (9.5% and 9.5%), while the incidence of diarrhea was 4.8%. Conclusions. Nintedanib as add-on treatment in post-COVID-19 lung fibrosis did not improve oxygenation, chest X-ray findings, or the 60-day mortality. However, this antifibrotic drug improved SpO2/FiO2 ratio in our patients. Further randomized controlled trials are needed to determine the efficacy of nintedanib for treatment of patients with post-COVID-19 lung fibrosis. Trial Registration. This study was registered in TCTR20220426001.http://dx.doi.org/10.1155/2022/9972846 |
| spellingShingle | Narongkorn Saiphoklang Pimchanok Patanayindee Pitchayapa Ruchiwit The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study Critical Care Research and Practice |
| title | The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study |
| title_full | The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study |
| title_fullStr | The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study |
| title_full_unstemmed | The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study |
| title_short | The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study |
| title_sort | effect of nintedanib in post covid 19 lung fibrosis an observational study |
| url | http://dx.doi.org/10.1155/2022/9972846 |
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