Therapeutic effects of nintedanib are not influenced by emphysema in the INPULSIS trials

Emphysema is a common comorbidity in patients with idiopathic pulmonary fibrosis (IPF) [1–4]. Due to the combination of restrictive and obstructive effects, patients with concomitant IPF and emphysema typically present with normal or elevated forced vital capacity (FVC) but reduced diffusing capacity [5]. Data from retrospective studies have demonstrated that lung function decline is attenuated in patients with IPF who have emphysema [6], with some evidence suggesting a threshold for extent of emphysema beyond which FVC decline is reduced [7]. In post hoc analyses of pooled data from the INPULSIS trials, the treatment effect of nintedanib versus placebo was not influenced by the presence of emphysema (yes versus no) or by FEV1/FVC ratio (≥0.7 to ≤0.8 versus >0.8) at baseline http://ow.ly/Gmwn30nwPY1