Weight loss on nintedanib therapy in interstitial lung diseases (ILD)

<bold>BACKGROUND:</bold> Nintedanib is an antifibrotic drug which slows down the progression of lung fibrosis in Idiopathic pulmonary fibrosis (IPF), Progressive pulmonary fibrosis (PPF) and Systemic Sclerosis ILD (SSc-ILD). Weight loss during Nintedanib therapy remains to be an understudied adverse drug effect, with no reports from India. Hence, we assessed its prevalence and significance in our ILD cohort. <bold>METHODOLOGY:</bold> Between July 2022 and Nov 2023, ILD patients seen in Pulmonary Medicine were screened retrospectively. Those on Nintedanib therapy with at least one follow-up visit were included in the study. Their clinico-demographics, physiology and treatment details were extracted from the electronic medical records. Weight loss on therapy was graded by the Common Terminology Criteria for Adverse Events (CTCAE) grade at 3, 6, 9 and 12 months of treatment. <bold>RESULTS:</bold> Out of 109 patients on Nintedanib, 61(56%) had a follow up. Of this 61 (57.4% males; mean age 57.69yrs±11.05; baseline weight 59.47kg±11.46; baseline FVC 1.64L±0.57), 34.4% were IPF and 57.4% were PPF. The mean weight loss at 3 months (n=38) was 0.94kg±2.88 (p<0.05), at 6 months (n=45) was 1.46kg±3.26 (p<0.05), at 9 months (n=8) was 2.37kg±4.03 and at 12 months (n=12) was 3kgs±5.9. The IPF and PPF cohorts had similar weight loss. At 6 months 17(37.8%) had significant weight loss. The baseline albumin level was significantly lower in the weight loss group (p<0.05). <bold>CONCLUSION:</bold> Weight loss is common during Nintedanib therapy but however, the mean weight loss in the Indian populace is lesser than in other published literature. The mean weight loss showed a serial rise with increasing duration. Further prospective studies are needed to find the associated risk factors.