{
  "abstract": "Introduction Nintedanib is an antifibrotic medication indicated for progressive fibrotic lung disease. Patients are usually started on full dose Nintedanib irrespective of their age, gender, body mass index (BMI) or ethnicity. Many patients are intolerant of full dose and medication is either reduced or discontinued. Our aim was to demonstrate clinically available predictive factors of full dose intolerance in a real-world cohort.Method We reviewed 127 patients initiated on Nintedanib at a single prescribing centre between December 2021 and October 2023. Patient data was obtained from electronic clinical records. Data was collected until there was dose reduction, discontinuation, or the last clinical entry prior to completion of the review in March 2025.The interval from Nintedanib initiation to the point of data collection was between 20–39 months.Results 51 patients (39.8%) tolerated 150 mg BD Nintedanib throughout, 71 (55.4%) required dose reduction and 5 (3.9%) were initiated at 100 mg.Female gender and an IPF diagnosis were significant predictive factors of intolerance of nintedanib at full dose (p<0.001 and p=0.042); older age was a near significant predictive factor (p=0.051).Treatment was given for a mean of 26.52 months (SD=5.38) with dose reduction occurring after 8.14 months (SD=6.72). Discontinuation occurred after 19.59 months (SD=6.82).Nintedanib was paused or reduced due to diarrhoea (39.4%), deranged liver function (9.2%) and weight loss (5.7%).Nintedanib was discontinued in 27 patients and was due to diarrhoea 38.4%, death 34.6%, weight loss 15.3%, patient choice 7.7% and nausea in 3.8%.20 patients passed away by the time of review with 10 in each group.Abstract P28 Table 1Demographics and resultsConclusion This single centre, retrospective real-world study has demonstrated significant rates of side effects and intolerance to Nintedanib 150 mg BD.It suggests that female gender and older age are predictive factors of intolerance of full dose Nintedanib.These findings warrant further investigation in a UK wide cohort which is planned for 2026, to further explore and consolidate these findings and potentially highlight others including ethnicity which wil be vital to guide clinicians to enable prescription of a dose that will be better tolerated from the outset and improve patient experience.",
  "authors": [
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK"
      ],
      "name": "S Marguerie"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK"
      ],
      "name": "A Alkhdour"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK"
      ],
      "name": "I Adhikari"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK"
      ],
      "name": "K Amcha"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK"
      ],
      "name": "L Elton-Walters"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK",
        "NIHR Southampton Respiratory Biomedical Research Centre, Southampton, UK",
        "University of Southampton, Southampton, UK"
      ],
      "name": "MG Jones"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK"
      ],
      "name": "RM Limbrey"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK",
        "NIHR Southampton Respiratory Biomedical Research Centre, Southampton, UK"
      ],
      "name": "T Wallis"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK",
        "NIHR Southampton Respiratory Biomedical Research Centre, Southampton, UK"
      ],
      "name": "BG Marshall"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK"
      ],
      "name": "KM Spinks"
    },
    {
      "affiliations": [
        "University Hospital Southampton, Southampton, UK",
        "NIHR Southampton Respiratory Biomedical Research Centre, Southampton, UK"
      ],
      "name": "SV Fletcher"
    }
  ],
  "title": "P28 Little women looking into antifibrotic tolerance in relation to weight, dose, female gender and ethnicity",
  "uid": "a62de5ec-7036-5062-b354-bcb6eb44eea9"
}