The drug nintedanib appears safe and well-tolerated in patients over 80 years of age with mild to moderate idiopathic pulmonary fibrosis (IPF), according to a study published in Respiration. 

IPF is a progressive, fibrosing interstitial lung disease of unknown cause. Its incidence increases with age, an unfortunate reality considering that many elderly individuals already have a number of comorbidities and are often frail. Studies indicate that old age is a predictor of mortality in IPF. 

Nintedanib is a multitarget tyrosine kinase inhibitor that has been shown to slow disease progression in IPF. It slows decline in forced vital capacity (FVC) and limits the risk of exacerbations. At present, medical literature is silent on the use of this drug in patients with IPF over 80 years of age vs patients who are younger. 

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The authors of the study investigated and compared the decline of FVC after 12 months of therapy in patients over the age of 80 and younger patients. Other parameters on safety and tolerability were likewise assessed. 

Read more about IPF etiology 

The research team enrolled adult patients with mild to moderate IPF between October 2018 and February 2022. Participants must have completed at least 3 months of nintedanib to be eligible for the study. Patients with severe IPF, defined as having a FVC less than 50% of predictive value, were excluded from the study. The researchers recruited 53 patients above the age of 80 and 159 patients who were younger. 

“We showed that nintedanib is effective and safe in this subset of patients [over the age of 80], without any significant differences from those aged ≤ 80 years,” the authors wrote. 

In addition, the research team did not find any significant differences between older and younger patients in terms of adverse effects. The data, however, indicated that the use of nintedanib in older patients can improve functional decline when baseline FVC is greater than 90%; in addition, the rate of patients with improved FVC after 1 year of treatment was not age dependent. 

“In conclusion, our study showed that nintedanib is effective and safe in patients with IPF aged > 80 years, without any significant differences with younger patients,” the authors said. 


Mondoni M, Alfano F, Varone F, et al. Observational, multicenter study on the efficacy, tolerability, and safety of nintedanib in patients with idiopathic pulmonary fibrosis older than 80 yearsRespiration. 2022;1-9. doi:10.1159/000527308