RIDGEFIELD, Conn., Sept. 17, 2018 /PRNewswire/ -- Results from INPULSIS-ON, published today in Lancet Respiratory Medicine, provide insights into the long-term safety, efficacy and tolerability of Ofev® (nintedanib) in patients with idiopathic pulmonary fibrosis (IPF). These data suggest that the effect of Ofev on slowing disease progression of IPF persists beyond four years. Results also indicate that the long-term efficacy of Ofev in reducing disease progression may be sustained in patients who require dose adjustments. 

The exploratory findings of the open-label extension trial are consistent with results from the Phase III INPULSIS trials and show that continued treatment with Ofev, for up to 68 months, has a manageable safety and tolerability profile, with no new safety signals identified. The INPULSIS-ON trial featured a large cohort of patients with IPF who received Ofev, and these data add to the growing body of evidence suggesting that Ofev provides long-term benefits to patients with IPF.

IPF is a rare, debilitating and fatal lung disease that affects as many as 132,000 Americans. It causes progressive scarring of the lungs, resulting in continuous and irreversible deterioration in lung function and breathing difficulties. As IPF progresses, lung function gradually and irreversibly deteriorates. 

In the INPULSIS-ON trial, involving 734 patients:

• Descriptive efficacy assessments of lung function showed the annual rate of decline in forced vital capacity (FVC) over 192 weeks was -135.1 mL/year. This was consistent with the annual rate of FVC decline in patients treated with Ofev in the INPULSIS trials (-113.6 mL/year in patients treated with Ofev). Data from clinical trials suggest that FVC decline in placebo-treated patients with IPF and mild or moderate lung function impairment at baseline is approximately 200 mL over 1 year.
• The annual rate of decline in FVC was consistent irrespective of age, race and FVC % predicted at the start of INPULSIS-ON.
• The incidence rate of acute exacerbations in INPULSIS-ON was similar to that in patients treated with Ofev in the INPULSIS trials, further supporting the effect of Ofev on reducing the risk of acute exacerbation.
• An acute exacerbation is a sudden deterioration in respiratory function, in many cases with unknown cause, which negatively impacts the disease course and often leads to death within a few months.

The most common adverse event during INPULSIS-ON was diarrhea, as in the INPULSIS and TOMORROW trials, and led to treatment discontinuation in 4.7% and 10.2% of patients who continued and initiated Ofev during INPULSIS-ON, respectively. Cardiovascular (major adverse cardiac and vascular events, e.g., heart attack or stroke) and bleeding exposure-adjusted event rates collected in patients who continued or initiated Ofev in INPULSIS-ON were similar to those observed in placebo-treated patients in the INPULSIS trials. These findings are also consistent with post-marketing surveillance data collected in the US during the first year following the launch of Ofev as a treatment for IPF.

"We are encouraged by these results showing that Ofev slows disease progression of IPF beyond four years," said Mitchell Kaye, M.D., president of Minnesota Lung Center/Minnesota Sleep Institute, Minneapolis. "These findings offer real hope to people with IPF and provide further supportive evidence for the long-term efficacy of Ofev."

Dr. Susanne Stowasser, Associate Head of Medicine Respiratory at Boehringer Ingelheim said: "The INPULSIS-ON results provide valuable insights about the long-term safety and efficacy of Ofev in IPF and supply further evidence of its positive impact on the lives of people living with this disease." Dr. Stowasser added: "Progressive fibrosing lung diseases like IPF continue to have a devastating impact on people's lives and our focus remains on researching and bringing to market treatments that improve the lives of these patients at need."

About the INPULSIS-ON trial
INPULSIS-ON was an open-label extension trial initiated in 2012, evaluating the tolerability, safety and efficacy of Ofev in patients with IPF. Patients were eligible if they had completed one of the replicate 52-week INPULSIS trials. The primary objective of the INPULSIS-ON trial was to characterize the long-term safety and tolerability of Ofev in patients with IPF, assessed via clinical and laboratory evaluation and the recording of adverse events. Exploratory efficacy endpoints included the annual rate of decline in FVC calculated over 192 weeks, absolute change in FVC (mL) from baseline to week 192, time to first acute exacerbation and time to death. Of the 734 patients treated in INPULSIS-ON, 430 had received Ofev in INPULSIS and continued Ofev in INPULSIS-ON, while 304 had received placebo in INPULSIS and initiated Ofev in INPULSIS-ON. 

About idiopathic pulmonary fibrosis (IPF)
IPF is a rare and serious lung disease that causes permanent scarring of the lungs. It affects as many as 132,000 Americans, typically men over the age of 65. Early diagnosis and proper care are critical to helping people treat their condition.

About Ofev (nintedanib)
The U.S. Food and Drug Administration (FDA) approved Ofev for the treatment of idiopathic pulmonary fibrosis (IPF) on October 15, 2014. Ofev is one of the first FDA-approved drug treatments for IPF and the only kinase inhibitor approved to treat this disease.

The approval was based on findings from a robust clinical trial program involving more than 1,200 patients with IPF worldwide, and included the Phase II TOMORROW™ trial and the Phase III INPULSIS® trials (INPULSIS-1 and INPULSIS-2. All these studies were randomized, double-blind, placebo-controlled trials comparing Ofev 150 mg twice daily to placebo for 52 weeks. Both INPULSIS trials were identically designed while the TOMORROW study design was similar.

What is Ofev?
Ofev is a prescription medicine used to treat people with a lung disease called idiopathic pulmonary fibrosis (IPF). It is not known if Ofev is safe and effective in children.

Important Safety Information

What is the most important information I should know about Ofev (nintedanib)?

Ofev can cause harm, birth defects or death to an unborn baby. Women should not become pregnant while taking Ofev. Women who are able to become pregnant should have a pregnancy test before starting treatment and should use birth control during and for at least 3 months after your last dose. If you become pregnant while taking Ofev, tell your doctor right away.

What should I tell my doctor before using Ofev?

Before you take Ofev, tell your doctor if you have:

• liver problems
• heart problems
• a history of blood clots
• a bleeding problem or a family history of a bleeding problem
• had recent surgery in your stomach (abdominal) area
• any other medical conditions.

Tell your doctor if you:

• are pregnant or plan to become pregnant.
• are breastfeeding or plan to breastfeed. It is not known if Ofev passes into your breast milk. You should not breastfeed while taking Ofev.
• are a smoker. You should stop smoking prior to taking Ofev and avoid smoking during treatment.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements such as St. John's wort.

What are the possible side effects of Ofev?

Ofev may cause serious side effects.

TELL YOUR DOCTOR RIGHT AWAY if you are experiencing any side effects, including:

• Liver problems. Unexplained symptoms may include yellowing of your skin or the white part of your eyes (jaundice), dark or brown (tea colored) urine, pain on the upper right side of your stomach area (abdomen), bleeding or bruising more easily than normal, feeling tired, or loss of appetite. Your doctor will do blood tests regularly to check how well your liver is working during your treatment with Ofev.
• Diarrhea, nausea, and vomiting. Your doctor may recommend that you drink fluids or take medicine to treat these side effects. Tell your doctor if you have these symptoms, if they do not go away, or get worse and if you are taking over-the-counter laxatives, stool softeners, and other medicines or dietary supplements.
• Heart attack. Symptoms of a heart problem may include chest pain or pressure, pain in your arms, back, neck or jaw, or shortness of breath.
• Stroke. Symptoms of a stroke may include numbness or weakness on 1 side of your body, trouble talking, headache, or dizziness.
• Bleeding problems. Ofev may increase your chances of having bleeding problems. Tell your doctor if you have unusual bleeding, bruising, or wounds that do not heal and/or if you are taking a blood thinner, including prescription blood thinners and over-the-counter aspirin.
• Tear in your stomach or intestinal wall (perforation). Ofev may increase your chances of having a tear in your stomach or intestinal wall. Tell your doctor if you have pain or swelling in your stomach area.

The most common side effects of Ofev are diarrhea, nausea, stomach pain, vomiting, liver problems, decreased appetite, headache, weight loss, and high blood pressure.

These are not all the possible side effects of Ofev. For more information, ask your doctor or pharmacist. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/safety/medwatch or call 1-800-FDA-1088. 

About Boehringer Ingelheim
Boehringer Ingelheim Pharmaceuticals, Inc., based in Ridgefield, Conn., is the largest U.S. subsidiary of Boehringer Ingelheim Corporation.

Boehringer Ingelheim is one of the world's top 20 pharmaceutical companies. Headquartered in Ingelheim, Germany, the company operates globally with approximately 50,000 employees. Since its founding in 1885, the company has remained family-owned and today creates value through innovation for three business areas including human pharmaceuticals, animal health and biopharmaceutical contract manufacturing.

Boehringer Ingelheim is committed to improving lives and providing valuable services and support to patients and their families.  Our employees create and engage in programs that strengthen our communities. Please visit www.boehringer-ingelheim.us/csr to learn more about how we make more health through our Corporate Social Responsibility initiatives.

In 2017, Boehringer Ingelheim achieved net sales of about $20.4 billion (18.1 billion euros). R&D expenditure corresponds to approximately $3.4 billion (three billion euros), or 17.0 percent of its net sales.

For more information please visit www.boehringer-ingelheim.us, or follow us on Twitter @BoehringerUS.  

SOURCE Boehringer Ingelheim Pharmaceuticals

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