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The INBUILD trial evaluated nintedanib in patients with progressive fibrosing interstitial lung diseases other than idiopathic pulmonary fibrosis. The randomized placebo-controlled study showed that nintedanib slowed the rate of decline in forced vital capacity across a broad group of fibrosing ILDs with a progressive phenotype. The benefit was consistent across major diagnostic subgroups, supporting the concept that treatment decisions can sometimes be guided by disease behavior rather than diagnosis alone. The clinical relevance is substantial for pulmonary practice because patients with connective-tissue-disease-associated ILD, chronic hypersensitivity pneumonitis, and other fibrosing disorders may develop a progressive trajectory even when they do not meet criteria for IPF. For HCPs, the paper supports regular assessment of change over time and timely referral to an ILD-focused multidisciplinary service when progression is suspected. As with IPF, adverse effects—especially diarrhea—need active management. The findings directly support the conference’s emphasis on antifibrotics beyond classic IPF and on longitudinal imaging, pulmonary function, and trajectory rather than relying on a single scan or isolated measurement.
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The INBUILD trial evaluated nintedanib in patients with progressive fibrosing interstitial lung diseases other than idiopathic pulmonary fibrosis. The randomized placebo-controlled study showed that nintedanib slowed the rate of decline in forced vital capacity across a broad group of fibrosing ILDs with a progressive phenotype. The benefit was consistent across major diagnostic subgroups, supporting the concept that treatment decisions can sometimes be guided by disease behavior rather than diagnosis alone. The clinical relevance is substantial for pulmonary practice because patients with connective-tissue-disease-associated ILD, chronic hypersensitivity pneumonitis, and other fibrosing disorders may develop a progressive trajectory even when they do not meet criteria for IPF. For HCPs, the paper supports regular assessment of change over time and timely referral to an ILD-focused multidisciplinary service when progression is suspected. As with IPF, adverse effects—especially diarrhea—need active management. The findings directly support the conference’s emphasis on antifibrotics beyond classic IPF and on longitudinal imaging, pulmonary function, and trajectory rather than relying on a single scan or isolated measurement.
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