Decline in forced vital capacity in subjects with systemic sclerosis-associated interstitial lung disease in the SENSCIS trial compared with healthy reference subjects

• Published in: Respiratory research 2022-07, Vol.23 (1), p.1-178, Article 178
• Main Authors: Maher, Toby M, Bourdin, Arnaud, Volkmann, Elizabeth R, Vettori, Serena, Distler, Jörg H. W, Alves, Margarida, Stock, Christian, Distler, Oliver
• Format: Article
• Language: English
• Subjects: Age; Connective tissue diseases; Development and progression; Diagnosis; Dyspnea; Ethnicity; Human health and pathology; Humans; Life Sciences; Lung; Lung diseases; Lung Diseases, Interstitial; Minority & ethnic groups; Patient outcomes; Placebos; Pulmonary fibrosis; Pulmonology and respiratory tract; Respiratory function; Risk factors; Santé publique et épidémiologie; Scleroderma; Scleroderma (Disease); Scleroderma, Systemic; Sex; Systemic scleroderma; Systemic sclerosis; Vital Capacity
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-022-02095-6

Background The forced vital capacity (FVC) of healthy individuals depends on their age, sex, ethnicity and height. Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is characterised by loss of FVC. We compared FVC values in the subjects with SSc-ILD in the SENSCIS trial of nintedanib versus placebo with values from hypothetical matched healthy references. Methods The SENSCIS trial enrolled subjects with SSc with first non-Raynaud symptom in the prior [less than or equai to] 7 years, extent of fibrotic ILD on HRCT [greater than or equai to] 10%, and FVC [greater than or equai to] 40% predicted. FVC at baseline and decline in FVC over 52 weeks were compared with FVC values in hypothetical healthy reference subjects matched 1:1 to the subjects in the trial for age, sex, ethnicity and height, determined using equations published by the European Respiratory Society Global Lung Function Initiative. Results At baseline, mean (SD) FVC was 2460 (737) mL in the nintedanib group (n = 287) compared with 3403 (787) mL in the hypothetical matched healthy references. Mean (SD) FVC was 2544 (817) mL in the placebo group (n = 286) compared with 3516 (887) mL in the hypothetical matched healthy references. Mean (SE) changes in FVC at week 52, i.e., age-related loss of lung function, in the hypothetical healthy references matched to the nintedanib and placebo groups, respectively, were - 26.3 (0.5) mL and - 25.8 (0.5) mL. The difference in the change in FVC at week 52 between the nintedanib group and the hypothetical healthy references was 26.6 mL (95% CI: 1.2, 52.0; p = 0.04). The difference in the change in FVC at week 52 between the placebo group and the hypothetical healthy references was 77.5 mL (95% CI: 51.4, 103.7; p < 0.0001). Conclusions Subjects with SSc-ILD in the SENSCIS trial had impaired lung function at baseline and experienced further deterioration over 52 weeks. The decline in FVC in the placebo group was four-fold greater than in a hypothetical group of matched healthy references, whereas the decline in FVC in patients who received nintedanib was two-fold greater than in hypothetical healthy references. These data highlight the clinical relevance of the slowing of FVC decline provided by nintedanib. Trial registration Registered 5 November 2015, Keywords: Connective tissue diseases, Pulmonary fibrosis, Scleroderma, systemic, Vital capacity