Sarcopenia affects the outcomes and tolerability in patients with interstitial lung disease receiving nintedanib: a retrospective study.
- 1Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan.
- 2Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan. [email protected].
- 3Hirosaki University School of Medicine, 5 Zaifu-Cho, Hirosaki, 036-8562, Japan.
Abstract
Background
Nintedanib is approved for various interstitial lung diseases (ILDs). Although sarcopenia, which is characterized by a loss of skeletal muscle mass, is known to affect the outcome of ILD, the outcome of patients with sarcopenia receiving nintedanib remains unclear.Methods
Fifty-six patients with ILD who were initiated on nintedanib between 2015 and 2023 were included. On CT images obtained prior to the introduction of nintedanib, the thoracic skeletal muscle area at the T4 level was measured to estimate the skeletal muscle index (SMI). Patients with an SMI in the lowest quartile were defined as the sarcopenia group, and the remaining patients as the non-sarcopenia group. The times from the start of nintedanib to all-cause death (overall survival: OS) and the first acute exacerbation (exacerbation-free survival: EFS) were compared between the two groups. Dose reduction and discontinuation rate of nintedanib were also evaluated. The cut-off date was determined to be 5 years.Results
Whereas age, sex, and serum levels of albumin and Klebs von den Lungen-6 did not differ between the two groups, forced vital capacity (%FVC) (63.7% vs. 72.7%), diffusing capacity of the lung for carbon monoxide (%DLco) (41% vs. 55.9%) and body mass index (20.6 vs. 25.2 kg/m²) were significantly lower in the sarcopenia group (n = 14) than in the non-sarcopenia group (n = 42). The OS was significantly shorter in the sarcopenia group (26.5 months vs. not reached, P = 0.03). Similarly, EFS was significantly shorter in the sarcopenia group (15.8 vs. 44.6 months, P = 0.002). In the multivariate Cox proportional hazard models adjusted for age and sex, %FVC and baseline sarcopenia were significantly associated with OS (%FVC: hazard ratio (HR) 0.96, 95% confidence interval (CI) 0.93-0.98, P = 0.005, sarcopenia: HR 3.37, 95% CI 1.27-8.93, P = 0.01). Likewise, %FVC, %DLco and sarcopenia were significantly associated with EFS (%FVC: HR 0.96, 95% CI 0.93-0.98, P = 0.0004, %DLco: HR 0.96, 95% CI 0.94-0.98, P = 0.0006, sarcopenia. HR 2.79, 95% CI 1.23-6.34, P = 0.01). Although all patients in the sarcopenia group required a dose reduction or discontinuation of nintedanib, 21.5% of the non-sarcopenia group did not require such adjustments (P = 0.01).Conclusions
Patients with sarcopenia and ILD may benefit less from nintedanib.
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BibTeX
@article{miura2026sarcopenia,
title = {{Sarcopenia affects the outcomes and tolerability in patients with interstitial lung disease receiving nintedanib: a retrospective study.}},
author = {Toko Miura and Tomonori Makiguchi and Warabi Shibata and Mizuki Hirata and Masamichi Itoga and Hisashi Tanaka and Kageaki Taima and Sadatomo Tasaka},
journal = {BMC pulmonary medicine},
year = {2026},
month = aug,
doi = {10.1186/s12890-026-04564-w},
url = {https://europepmc.org/article/MED/42972370},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Sarcopenia affects the outcomes and tolerability in patients with interstitial lung disease receiving nintedanib: a retrospective study.
AU - Toko Miura
AU - Tomonori Makiguchi
AU - Warabi Shibata
AU - Mizuki Hirata
AU - Masamichi Itoga
AU - Hisashi Tanaka
AU - Kageaki Taima
AU - Sadatomo Tasaka
PY - 2026
DA - 2026/08/05
JO - BMC pulmonary medicine
DO - 10.1186/s12890-026-04564-w
UR - https://europepmc.org/article/MED/42972370
AB - Background Nintedanib is approved for various interstitial lung diseases (ILDs). Although sarcopenia, which is characterized by a loss of skeletal muscle mass, is known to affect the outcome of ILD, the outcome of patients with sarcopenia receiving nintedanib remains unclear.Methods Fifty-six patients with ILD who were initiated on nintedanib between 2015 and 2023 were included. On CT images obtained prior to the introduction of nintedanib, the thoracic skeletal muscle area at the T4 level was measured to estimate the skeletal muscle index (SMI). Patients with an SMI in the lowest quartile were defined as the sarcopenia group, and the remaining patients as the non-sarcopenia group. The times from the start of nintedanib to all-cause death (overall survival: OS) and the first acute exacerbation (exacerbation-free survival: EFS) were compared between the two groups. Dose reduction and discontinuation rate of nintedanib were also evaluated. The cut-off date was determined to be 5 years.Results Whereas age, sex, and serum levels of albumin and Klebs von den Lungen-6 did not differ between the two groups, forced vital capacity (%FVC) (63.7% vs. 72.7%), diffusing capacity of the lung for carbon monoxide (%DLco) (41% vs. 55.9%) and body mass index (20.6 vs. 25.2 kg/m²) were significantly lower in the sarcopenia group (n = 14) than in the non-sarcopenia group (n = 42). The OS was significantly shorter in the sarcopenia group (26.5 months vs. not reached, P = 0.03). Similarly, EFS was significantly shorter in the sarcopenia group (15.8 vs. 44.6 months, P = 0.002). In the multivariate Cox proportional hazard models adjusted for age and sex, %FVC and baseline sarcopenia were significantly associated with OS (%FVC: hazard ratio (HR) 0.96, 95% confidence interval (CI) 0.93-0.98, P = 0.005, sarcopenia: HR 3.37, 95% CI 1.27-8.93, P = 0.01). Likewise, %FVC, %DLco and sarcopenia were significantly associated with EFS (%FVC: HR 0.96, 95% CI 0.93-0.98, P = 0.0004, %DLco: HR 0.96, 95% CI 0.94-0.98, P = 0.0006, sarcopenia. HR 2.79, 95% CI 1.23-6.34, P = 0.01). Although all patients in the sarcopenia group required a dose reduction or discontinuation of nintedanib, 21.5% of the non-sarcopenia group did not require such adjustments (P = 0.01).Conclusions Patients with sarcopenia and ILD may benefit less from nintedanib.
SN - 1471-2466
ER -