A randomized trial found that nintedanib, a drug used for progressive lung fibrosis, offered no meaningful benefit over placebo in patients who developed interstitial lung disease (ILD) after severe COVID-19. Lung function, imaging, and patient-reported outcomes improved similarly in both groups over 180 days. Researchers suggest post-COVID ILD may be biologically different from other fibrotic lung diseases.
A randomized clinical trial published in the Annals of the American Thoracic Society found that nintedanib — a drug approved for progressive fibrotic lung diseases like idiopathic pulmonary fibrosis (IPF) — provided no significant benefit over placebo in patients who developed interstitial lung disease (ILD) following severe COVID-19 infection.
The trial enrolled 103 patients across six U.S. sites between November 2020 and July 2023. Participants received either 150 mg of nintedanib or a matching placebo twice daily for 180 days. Across all key measures — lung function (FVC), 6-minute walk distance, chest CT imaging, and patient-reported outcomes — there were no significant differences between the two groups. Notably, both groups showed improvement over time, suggesting that post-COVID ILD may naturally resolve rather than progressively worsen.
Key Takeaways:
Why it matters: These findings caution against reflexively applying IPF treatments to post-COVID lung complications. Clinicians should recognize that post-COVID ILD may follow a different, potentially self-resolving trajectory — shifting how we monitor and manage these patients going forward.
