Evidence map›Paper›PMID 34475231›Full record

Trial reportThe European respiratory journal2022

Nintedanib in progressive interstitial lung diseases: data from the whole INBUILD trial.

Kevin R Flaherty, Athol U Wells, Vincent Cottin, Anand Devaraj, Yoshikazu Inoue, Luca Richeldi, Simon L F Walsh, Martin Kolb, Dirk Koschel, Teng Moua and 5 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The European respiratory journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 4 pooled it
13.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 4 syntheses or guidelines pooled it, 112 citations in OpenAlex.

  1. Pooled it
  2. Lack of diversity in antifibrotic trials for pulmonary fibrosis: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2025
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  12. Review
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  15. Fibrotic chronic eosinophilic pneumonia: from inflammation to fibrosis and therapeutic implications.European respiratory review : an official journal of the European Respiratory Society · 2026
    Review
  16. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 11 institutions in 7 countries.

Kevin R FlahertyDivision of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
Athol U WellsNational Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
Vincent CottinNational Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, UMR 754, Lyon, France.ORCID 0000-0002-5591-0955
Anand DevarajDept of Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
Yoshikazu InoueClinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Japan.ORCID 0000-0003-3994-874X
Luca RicheldiFondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Simon L F WalshNational Heart and Lung Institute, Imperial College London, London, UK.
Martin KolbMcMaster University and St Joseph's Healthcare, Hamilton, ON, Canada.ORCID 0000-0003-3837-1467
Dirk KoschelFachkrankenhaus Coswig, Coswig, Germany.
Teng MouaDivision of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Rochester, MN, USA.
Susanne StowasserBoehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
Rainer-Georg GoeldnerBoehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany.
Rozsa Schlenker-HercegBoehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA.
Kevin K Brown
INBUILD Trial Investigators
Boehringer Ingelheim (Germany) · DERoyal Brompton & Harefield NHS Foundation Trust · GBBoehringer Ingelheim (United States) · USImperial College London · GBMayo Clinic in Florida · USNational Jewish Health · USNHO Kinki Chuo Chest Medical Center · JPSt. Joseph’s Healthcare Hamilton · CAUniversità Cattolica del Sacro Cuore · ITUniversité Claude Bernard Lyon 1 · FRUniversity of Michigan · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe primary analysis of the INBUILD trial showed that in subjects with progressive fibrosing interstitial lung diseases (ILDs), nintedanib slowed the decline in forced vital capacity (FVC) over 52 weeks. We report the effects of nintedanib on ILD progression over the whole trial.

methodsSubjects with fibrosing ILDs other than idiopathic pulmonary fibrosis, who had ILD progression within the 24 months before screening despite management deemed appropriate in clinical practice, were randomised to receive nintedanib or placebo. Subjects continued on blinded randomised treatment until all subjects had completed the trial. Over the whole trial, mean±sd exposure to trial medication was 15.6±7.2 and 16.8±5.8 months in the nintedanib and placebo groups, respectively.

resultsIn the nintedanib (n=332) and placebo (n=331) groups, respectively, the proportions of subjects who had ILD progression (absolute decline in FVC ≥10% predicted) or died were 40.4% and 54.7% in the overall population (hazard ratio (HR) 0.66, 95% CI 0.53-0.83; p=0.0003) and 43.7% and 55.8% among subjects with a usual interstitial pneumonia (UIP)-like fibrotic pattern on high-resolution computed tomography (HRCT) (HR 0.69, 95% CI 0.53-0.91; p=0.009). In the nintedanib and placebo groups, respectively, the proportions who had an acute exacerbation of ILD or died were 13.9% and 19.6% in the overall population (HR 0.67, 95% CI 0.46-0.98; p=0.04) and 15.0% and 22.8% among subjects with a UIP-like fibrotic pattern on HRCT (HR 0.62, 95% CI 0.39-0.97; p=0.03).

conclusionBased on data from the whole INBUILD trial, nintedanib reduced the risk of events indicating ILD progression.

Indexed as

Idiopathic Pulmonary FibrosisLung Diseases, InterstitialDisease ProgressionHumansIndolesProtein Kinase InhibitorsVital CapacityIndolesnintedanibProtein Kinase Inhibitors

Identifiers

PMID34475231
PMCPMC8927709
OpenAlexW3198752998

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.