ADDING NINTEDANIB TO IMMUNOSUPPRESSIVE THERAPY IN CONNECTIVE TISSUE RELATED INTERSTITIAL LUNG DISEASES; CASE SERIES BASED ON REAL-LIFE DATA FROM A SINGLE CENTRE

OpenAlex İngilizce

Connective tissue-related interstitial lung disease (CTD-ILD) is a severe process that progresses in approximately 30% of patients. These patients may need aggressive treatment. Therefore, new treatment strategies are being developed. Anti-fibrotic agents used in idiopathic pulmonary fibrosis are now being used in patients with a diagnosis of CTD-ILD. In the systemic sclerosis safety and efficacy study, the use of nintedanib in systemic sclerosis-related interstitial lung disease was shown to slow the loss of forced vital capacity (FVC). It has been shown to slow the loss of FVC. We retrospectively analyzed four patients diagnosed with CTD-ILD who used nintedanib for one year. The first two cases were diagnosed with systemic sclerosis, the third case with primary Sjögren’s disease, and the fourth case with anti-synthetase syndrome. FVC, carbon monoxide diffusion capacity, 6-minute walking test, and echocardiography data of the cases were obtained. High-resolution computerized tomography records available in the system were re-evaluated with semi-quantitative and quantitative methods (artificial intelligence). We added nintedanib to mycophenolate mofetil treatment in our first, second and fourth cases. In our third case, we added nintedanib to the rituximab treatment. No severe side effects were encountered due to the combined treatment. In our third case, the treatment was terminated due to progressive severe weight loss. Except for the third case, all patients showed improvement in the modified borg dyspnea indices. In our second case, both semi-quantitative and quantitative interstitial lung disease scores were regressed. CTD-ILD is a complex pathology that requires patient-specific evaluation and personalized treatment. Immunosuppressive therapy was modified in all our patients. Immunosuppressive therapy is vital in the treatment of CTD-ILD. Patients with progressive pulmonary fibrosis should receive adequate and effective doses of immunosuppressive therapy. Despite this, treatment should be modified in patients with progression. The addition of nintedanib may contribute to the treatment of these patients.