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The Nintedanib in Progressive Pneumoconiosis Study (NiPPS): a Collaborative NSW Treatment Trial

Phase 2
Recruiting
Conditions
Pneumoconiosis Coal
Asbestosis
Silicosis
Interventions
Registration Number
NCT04161014
Lead Sponsor
Holdsworth House Medical Practice
Brief Summary

Prospective clinical pilot study for subjects diagnosed with Occupational Progressive Pneumoconiosis.

Subjects will be treated with Nintedanib 150mg twice daily for 3 years.

Detailed Description

100 Patients with asbestosis, silicosis, coal workers pneumoconiosis and diffuse dust fibrosis will be included. Patients will have an FVC ≥45% predicted (no upper threshold), and a diffusion capacity of the lung for carbon monoxide (TLCO) above 30% predicted. Patients will be randomised to receive Nintedanib 150 mg twice daily, with the dose of the study drug reduced to 100 mg twice daily or interrupted temporarily in the case of adverse events (AEs).The primary end point will be the annual decline in FVC, measured in millilitres per year, calculated from serial measurements over 36 months.

Lung function testing will be performed at baseline; 2, 4, 6, 12, 18, 24, 30, 36, 44 and 52 weeks, and every 4 months thereafter until study cessation or withdrawal at a maximum of 36 months.

In patients who show clinical benefit as per the end points specified access to Nintedanib treatment will be continued.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Pneumoconiosis diagnosis confirmed at the Occupational MDT (Occ-MDT)
  • diffuse fibrosing lung disease of extent >10% on HRCT with protocol criteria for progression
  • Asbestosis, silicosis, coal worker's pneumoconiosis and diffuse dust fibrosis
  • FVC ≥45% predicted and TLCO above 30% predicted
Exclusion Criteria
  • idiopathic pulmonary fibrosis (IPF) and non-occupational progressive pulmonary fibrosis
  • ILD due to connective tissues disorders, hypersensitivity pneumonitis, non-occupational interstitial pneumonia, non-occupational sarcoidosis
  • contraindications to Nintedanib (forthcoming surgery, use of anticoagulants, high CVD risk, liver function abnormalities)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment ArmNintedanib 150 MG [Ofev]Nintedanib 150mg twice daily for 3 years
Primary Outcome Measures
NameTimeMethod
annual decline in FVC36 months

measured in millilitres per year, calculated from serial measurements

Secondary Outcome Measures
NameTimeMethod
K-BILD scoreweek 52

Absolute change from baseline in King's Brief Interstitial Lung Disease Questionnaire (K-BILD) total score. The KBILD domain and total score ranges are 0-100; 100 represents best health status

Time to acute exacerbation36 months

an acute, clinically significant respiratory deterioration characterized by evidence of new, widespread alveolar abnormality, including unexplained worsening or development of dyspnea,new diffuse pulmonary infiltrates visualized on chest radiography, HRCT, or both, or the development of parenchymal abnormalities with no pneumothorax or pleural effusion (new ground-glass opacities) since the preceding visit; and exclusion of any known causes of acute worsening, including infection, left heart failure, pulmonary embolism, and any identifiable cause of acute lung injury, in accordance with routine clinical practice and microbiologic studies.

Time to referral for Lung transplantation36 months

Respiratory deterioration which necessitates a referral for lung transplant

Time to death12, 24 and 36 months

Respiratory deterioration leading to death

Trial Locations

Locations (1)

Holdsworth House Medical Practice

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Sydney, New South Wales, Australia

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