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Nintedanib for treating progressive fibrosing interstitial lung diseases excluding idiopathic pulmonary fibrosis

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1 Recommendations

1.1 Nintedanib is not recommended, within its marketing authorisation, for treating progressive fibrosing interstitial lung diseases in adults (except idiopathic pulmonary fibrosis, for which it is recommended in NICE technology appraisal guidance 379).

1.2 This recommendation is not intended to affect treatment with nintedanib that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Why the committee made these recommendations

Current treatment for fibrosing interstitial lung disease starts with immunosuppressants. If recommended, nintedanib would be given at the same time. The clinical trial evidence suggests that nintedanib slows the decline of lung function compared with placebo. But, follow up was short so it was unclear whether people live longer. It is also uncertain what its effects would be in clinical practice because the trial restricted use of some immunosuppressants in the first 6 months. The economic model was also uncertain because of the company's modelling of survival in the placebo arm, nintedanib's long-term benefits, and for how long people would take it.

Because of these uncertainties, it is not possible to estimate nintedanib's cost effectiveness. Therefore, nintedanib is not recommended.