Late Breaking Abstract - Dietetic intervention in malnourished patients with interstitial lung disease (ILD): a pilot trial

<bold>Background:</bold> Malnutrition in ILD is associated with poor prognosis, yet the impact of dietetic input is unknown. <bold>Aim:</bold> Feasibility of a randomised controlled trial of dietary intervention in ILD. <bold>Methods:</bold> ILD patients with or at risk of malnutrition were randomised to a 12-week specialist dietetic intervention (individualised nutrition support advice) or control arm receiving a dietary leaflet. Baseline demographics, smoking history, comorbidities, antifibrotic drugs, lung function, respiratory & gut symptoms questionnaires were collected. Weight was measured at 0, 2, 4, 8 and 12 weeks. <bold>Results:</bold> Forty patients were recruited within 7 months from 128 referrals (06/23-01/24) and 100% completed the trial. The mean weight loss in the year prior to trial entry was 8.2 kg (95% CI:6.4-10). 65% of the patients (13 in each arm), were treated with anti-fibrotic drugs (5 pirfenidone, 21 nintedanib). Analysing repeated weight measures with mixed linear regression, there was an average weight loss (95% CI) in the control group of -0.33kg/month (−0.53 to -0.13, ≠0, p=0.001), compared to a gain (95% CI) of +0.14kg/month (−0.11 to 0.39 ≠0, NS vs 0) in the diet group. The monthly difference between the arms was +0.47 (0.15 to 0.79) Kg/month (p=0.004). On multivariable analysis, the monthly weight difference remained significant after adjustment for age, sex, smoking, Charlson co-morbidity index, baseline BMI, anti-fibrotic drugs, and composite physiological index (+0.47 kg/m; 95%CI: 0.12-0.83, p=0.009). <bold>Conclusion:</bold> This is the first trial of a dietary intervention in ILD. The intervention was feasible, with excellent retention, & significantly reversed ongoing weight loss in ILD patients.