ReviewAmerican journal of translational research2026
Efficacy and safety of nintedanib combined with pirfenidone versus monotherapy in patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis.
Review in American journal of translational research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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.
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Who cites it
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This systematic review and meta-analysis, registered in PROSPERO (CRD420261306598) and conducted following PRISMA guidelines, evaluates the efficacy and safety of nintedanib combined with pirfenidone versus monotherapy in idiopathic pulmonary fibrosis (IPF). PubMed, Embase, Cochrane Library, Web of Science, and Chinese databases (CNKI, Wanfang, VIP) were searched from inception to January 15, 2026. Eleven studies comprising 629 unique patients were included. For efficacy, the combination therapy group showed a trend toward reduced monthly forced vital capacity (FVC) decline (mean difference [MD]=8.50 mL, 95% CI: -1.18 to 18.18, P=0.085), which became significant after excluding a small-sample study (MD=11.76 mL, 95% CI: 4.71 to 18.81, P<0.05). The 6-minute walk distance (6MWD) significantly improved with combination therapy (MD=21.81 m, 95% CI: 4.84 to 38.77, P=0.012). For safety, no significant differences were found between groups in gastrointestinal adverse reactions (risk ratio [RR]=0.67, 95% CI: 0.26 to 1.70), treatment discontinuation (RR=1.23, 95% CI: 0.41 to 3.73), or serious adverse events (SAEs) (RR=0.93, 95% CI: 0.24 to 3.65). Subgroup and sensitivity analyses confirmed result robustness. In conclusion, nintedanib combined with pirfenidone may offer additional benefits in preserving lung function and improving exercise capacity in IPF patients without compromising safety, supporting its consideration as a therapeutic strategy.
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