PD417 - SKELETAL MUSCLE MASS IS ASSOCIATED WITH PROGNOSIS IN PATIENTS WITH INTERSTITIAL LUNG DISEASE RECEIVING NINTEDANIB

PD417

SKELETAL MUSCLE MASS IS ASSOCIATED WITH PROGNOSIS IN PATIENTS WITH INTERSTITIAL LUNG DISEASE RECEIVING NINTEDANIB

T. Ogasawara^1,2,*, M. Sugiura³, M. Ogiku⁴, Y. Miyazawa⁵

¹General Internal Medicine, ²Respiratory Medicine, ³Nutrition, ⁴Surgery, ⁵Rehabilitation, Hamamatsu Medical Center, Hamamatsu, Japan

Rationale: Mortality in interstitial lung disease (ILD) remains high and appears to be increasing. Although nintedanib is a key antifibrotic therapy, prognostic markers in treated patients are not well established. We therefore investigated whether chest computed tomography (CT) disease extent and skeletal muscle mass are associated with overall survival in patients receiving nintedanib.

Methods: This retrospective study included 63 patients with ILD who received nintedanib at our hospital between April 2016 and July 2024. Chest CT images obtained before nintedanib initiation were analyzed using a commercially available CT image analysis workstation. Inflammatory and fibrosing lung volume (IFLV) was defined as the percentage of total lung volume with attenuation values between −700 and 100 Hounsfield units. The erector spinae muscle index (ESMI) was measured at the 12th thoracic vertebral level and normalized by height squared. The cutoff value for IFLV was determined using receiver operating characteristic curve analysis, whereas that for ESMI was defined as the lowest quartile of the study population.

Results: Both IFLV > 28.6% and ESMI < 8 cm²/m² were associated with poor prognosis (log-rank test, P = 0.001 and P = 0.03, respectively). In both the high- and low-IFLV groups, low skeletal muscle mass was associated with worse survival. After adjustment for sex, age, and physiology (GAP index), ESMI < 8 cm²/m² remained an independent predictor of overall survival (hazard ratio, 3.20; 95% confidence interval, 1.35–7.54; P = 0.007).

Conclusion: In patients with ILD receiving nintedanib, low skeletal muscle mass was independently associated with overall survival and may provide additional prognostic value beyond CT-derived disease extent.

Disclosure of Interest: None declared