Discussion
fibrosing RA-ILD, RA, IPF, inflammation
ADVERSE EVENTS, DISEASE PROGRESSION, ADVERSE EVENT, INFLAMMATION
These data from the INBUILD trial show that nintedanib reduced the rate of decline in FVC over 52 weeks in patients with progressive fibrosing RA-ILD by 59% compared with placebo, similar to the relative treatment effect observed in the overall trial population [Decline in FVC in patients with ILDs is reflective of disease progression and is associated with mortality [CRP is a marker of inflammation [Acute exacerbations associated with high morbidity and mortality are a feature of the natural history of IPF [The adverse event profile of nintedanib in patients with RA-ILD in the INBUILD trial was consistent with observations in the overall trial population [DMARDs are an important part of the management of patients with RA, according to international management guidelines [Strengths of our analyses include the randomised placebo-controlled trial design, with standardised reporting of outcomes and adverse events. Limitations include that the INBUILD trial was not designed or powered to study individual ILDs and the number of patients with RA-ILD was small, limiting the potential for subgroup analyses including those based on concomitant medication use. There are no adequately validated patient-reported outcomes for assessing changes in symptoms or quality of life due to worsening of RA-ILD. Data on RA disease activity were not collected.