Can Treprostinil Change IPF Care?

Inhaled treprostinil resulted in a smaller decline in lung function and fewer clinical‐worsening events than placebo over 52 weeks.

Category	Detail
Condition	Idiopathic Pulmonary Fibrosis (IPF)
Key Mechanisms	Inhaled treprostinil administered to reduce decline in forced vital capacity (FVC).
Target Population	Patients aged 40 years or older with diagnosed IPF and FVC at least 45% of predicted value.
Care Setting	Phase 3 randomized controlled trial conducted at 94 sites in the US and Canada.

Treprostinil resulted in a smaller decline in FVC compared to placebo.
Clinical worsening events were fewer in the treprostinil group (32%) than in the placebo group (45%).
The median change in FVC at week 52 was -43 mL with treprostinil vs -196 mL with placebo.
Cough occurred in 55% of patients receiving treprostinil.
Discontinuation rates were higher in the treprostinil group (41%) compared to placebo (33%).

Diagnosis of IPF should follow the 2018 ATS/ERS/JRS/ALAT clinical practice guidelines.

Inhaled treprostinil may be considered for patients with IPF to reduce FVC decline.

Adverse events led to discontinuation in 21% of patients receiving treprostinil.

Patients with idiopathic pulmonary fibrosis aged 40 years or older.

Stable doses of nintedanib or pirfenidone required for at least 30 days prior to baseline.

Conduct high-resolution computed tomography scans and review surgical lung-biopsy specimens for accurate diagnosis.
Stratify randomization by background antifibrotic therapy.