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The INPULSIS trials established the antifibrotic nintedanib as a disease-modifying treatment for idiopathic pulmonary fibrosis. Across two randomized, placebo-controlled studies, nintedanib significantly reduced the annual rate of decline in forced vital capacity compared with placebo. The drug did not reverse established fibrosis; its value was in slowing functional deterioration. Diarrhea was a common adverse effect and an important practical issue for treatment persistence. For HCPs, the paper supports early consideration of antifibrotic therapy once the diagnosis of IPF is established and an appropriate multidisciplinary assessment has been completed. It also reinforces the need to distinguish disease-modifying treatment from symptom-focused care, pulmonary rehabilitation, and management of comorbidities—each remains important even when antifibrotic therapy is started. The evidence fits the conference’s ILD program, particularly the emphasis on antifibrotics and longitudinal assessment. A useful clinical habit is to follow trajectory rather than a single FVC value, combining serial lung function, symptoms, oxygenation, imaging, and functional status when assessing progression and response.
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The INPULSIS trials established the antifibrotic nintedanib as a disease-modifying treatment for idiopathic pulmonary fibrosis. Across two randomized, placebo-controlled studies, nintedanib significantly reduced the annual rate of decline in forced vital capacity compared with placebo. The drug did not reverse established fibrosis; its value was in slowing functional deterioration. Diarrhea was a common adverse effect and an important practical issue for treatment persistence. For HCPs, the paper supports early consideration of antifibrotic therapy once the diagnosis of IPF is established and an appropriate multidisciplinary assessment has been completed. It also reinforces the need to distinguish disease-modifying treatment from symptom-focused care, pulmonary rehabilitation, and management of comorbidities—each remains important even when antifibrotic therapy is started. The evidence fits the conference’s ILD program, particularly the emphasis on antifibrotics and longitudinal assessment. A useful clinical habit is to follow trajectory rather than a single FVC value, combining serial lung function, symptoms, oxygenation, imaging, and functional status when assessing progression and response.
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