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Although there have been no reports suggesting the development of pneumothorax with nintedanib use, its safety in patients with impaired lung function is unclear. We observed the development of refractory spontaneous pneumothorax during nintedanib therapy in two patients with SSc\u2010ILD and impaired lung function. Nintedanib use for SSc\u2010ILD, an extensive disease, may therefore increase the risk of pneumothorax. In addition, pneumothorax is more likely to be refractory in these cases; initiation of nintedanib treatment and follow\u2010up should be considered carefully.<\/jats:p>","DOI":"10.1002\/rcr2.716","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T04:01:45Z","timestamp":1611806505000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Spontaneous pneumothorax during nintedanib therapy in patients with systemic sclerosis\u2010associated interstitial lung disease"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-5878","authenticated-orcid":false,"given":"Toshiyuki","family":"Sumi","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine Hakodate Goryoukaku Hospital  Hakodate Japan"},{"name":"Department of Respiratory Medicine and Allergology Sapporo Medical University School of Medicine  Sapporo 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