NICE has approved the use of nintedanib (Ofev) on the NHS in patients with idiopathic pulmonary fibrosis, provided the following conditions are met:
NICE technology appraisal TA379
- the patient has a forced vital capacity (FVC) between 50% and 80% of predicted
- the discount agreed in the patient access scheme is honoured by the manufacturer
- treatment is stopped if there is a confirmed decline in percent predicted FVC of 10% or more in any 12-month period.
The recommendation to discontinue nintedanib in the event of disease progression was deemed to improve cost-effectiveness by minimising continued treatment when the drug is no longer effective. The 10% threshold was obtained from a similar appraisal of pirfenidone.
Nintedanib targets tyrosine kinases involved in pulmonary fibrosis. It is thought to block signalling pathways responsible for fibrotic processes, and may reduce disease progression by slowing the decline of lung function.