IPF edition · Most recent idiopathic pulmonary fibrosis conclusions
Last updatedMonday, November 2, 20266:43 AM ET
Today's headlineBristol Myers Squibb says its pill admilparant met its main goal in a Phase 3 IPF trial (Oct 12, company-reported). The FDA is reviewing inhaled treprostinil (Tyvaso) for IPF, and Jascayd (nerandomilast), the newest IPF pill, won EU approval in July 2026.
Idiopathic pulmonary fibrosis has no cure yet. Three pills now slow it, and an inhaled option is under FDA review.
Cure Checker's conclusion · Oct 2026
Most recent cure information
There is no cure for idiopathic pulmonary fibrosis (IPF). It scars the lungs for reasons no one yet understands, and the scarring is permanent. Three pills are FDA approved: nintedanib (Ofev), pirfenidone (Esbriet) and, since October 7, 2025, nerandomilast (Jascayd). All three slow the loss of lung function. None stops or reverses it. A lung transplant can replace scarred lungs, but it is an option only for some people. Our view: progress now comes from adding treatments together, and an inhaled drug, treprostinil, is under FDA review. A cure would have to stop or undo the scarring, and no treatment has shown that yet.
A third pill.The FDA approved Jascayd on October 7, 2025 for IPF and on December 19, 2025 for progressive pulmonary fibrosis. In its 1,177-person trial, the 18 mg dose slowed lung-function loss by 68.8 mL more than placebo over a year.
An inhaled option is under review.Two Phase 3 trials (TETON-1 and TETON-2) found inhaled treprostinil slowed lung-function loss. The FDA accepted the application, and the company expects a decision in late April 2027.
A survival signal, not yet proof.A July 2026 pooled analysis linked Jascayd 18 mg to a lower risk of death. In the IPF trial alone, the difference in deaths was not statistically clear.
Cheaper copies are coming.The FDA approved the first generic versions of nintedanib on April 2, 2026. Generic pirfenidone has been FDA approved since January 2022.
This is Cure Checker's editorial assessment of published evidence, not medical advice. Care decisions belong with a lung specialist experienced in pulmonary fibrosis.
A possible missing link
Please read first. This is an AI-generated hypothesis, written by Cure Checker's AI from published research. It is speculation, not an established finding. It is not a recommendation, not a prediction that a cure exists, and not medical advice. No doctors or scientists have reviewed it, and it may be wrong. Never start, stop, change or delay any treatment because of it. Talk with your lung specialist.
What looks like it is working
Slowing the scarring. In 1,177 people, most already on nintedanib or pirfenidone, nerandomilast slowed lung-function loss versus placebo over a year (NEJM, 2025). Inhaled treprostinil did the same in 593 people (NEJM, 2026).
Spotting early changes on CT. In four research groups, 7% to 9% of people had small scar-like changes on chest CT, linked to a higher risk of death (JAMA, 2016). These changes share several risk genes with IPF, including MUC5B (Am J Respir Crit Care Med, 2019).
Finding faulty repair cells. IPF lungs hold unusual "aberrant basaloid" cells at the edge of scar areas (Sci Adv, 2020). In mice, removing similar stuck repair cells reduced scarring (Nat Commun, 2026). This is animal work.
Testing earlier treatment. A placebo-controlled trial (DROP-FPF) is testing nerandomilast in about 80 people with early CT changes and a close relative with pulmonary fibrosis; it is still recruiting (ClinicalTrials.gov).
Where the links are missing
Faulty repair may come first. A study not yet peer reviewed found these cells already present in early IPF, and more of them were linked to later worsening (bioRxiv preprint, 2026). Our inference: the trouble may start in the air-sac lining.
No drug aimed at the lining cells. A 2025 review treats replacing these cells with cell therapy as a strategy still being worked out (Am J Respir Cell Mol Biol, 2025). Our inference: we found no human trial of a drug designed to help these cells finish healing, though we may have missed one.
No simple way to see them.Our inference: we found no validated blood or scan test for these cells, so early trials choose people by CT changes and family history.
Our hypothesis
Could stuck repair cells in the air-sac lining be an early driver of IPF, already present when CT shows only small changes? If so, could a test that does not yet exist find them, and a treatment that helps them finish healing, which also does not yet exist, stop scarring from taking hold instead of only slowing it?
What would prove it wrong: if people with early CT changes do not carry more of these cells than others, or if clearing or fixing the cells in people does not slow lung-function loss.
Hypothesis written October 6, 2026. Cure Checker's AI will revisit it when major new evidence appears.
Latest studies & what they concluded
Newest first. Updated each morning as results, trial launches and papers are published.
CAL101 Phase 2 AURORA trial finishes dosing
Calluna Pharma said all dosing is done in its Phase 2 trial of CAL101, a monthly infusion, in 161 adults with IPF. An independent safety committee reviewed the unblinded safety data and found nothing that required changes to the trial. Main results, on lung capacity (FVC), are expected in the first quarter of 2027. This is a company announcement reported by trade press; there are no efficacy results and it is not approved.
Admilparant: ALOFT-IPF Phase 3 meets its main goal
Bristol Myers Squibb said its twice-daily LPA1-blocking pill beat placebo on change in lung capacity (FVC) at 52 weeks at the 60 mg dose, in about 1,255 adults. The 120 mg dose slowed decline but not by a statistically clear amount. The company called the pill well tolerated, with few stops for side effects. No numbers were given yet. This is a company announcement, not peer-reviewed, and it is not approved.
Inhaled treprostinil in IPF: pooled analysis of the two TETON trials (Adv Respir Med)
A review pooling TETON-1 and TETON-2 found that at 52 weeks inhaled treprostinil kept FVC about 111 mL higher than placebo and lowered the risk of clinical worsening (HR 0.69) and acute flare-ups (HR 0.52). Deaths from any cause did not differ by a statistically clear amount (HR 0.70, 95% CI 0.47 to 1.05). Cough, headache and stopping the drug for side effects were more common with treprostinil. It pools two company-run trials, and it is not approved for IPF yet (FDA review is underway).
Celea Therapeutics described a global trial of about 1,100 adults with IPF who are not on an antifibrotic. It compares deupirfenidone 825 mg three times daily with pirfenidone 801 mg three times daily, and the main goal is the change in FVC at 52 weeks. It follows the positive Phase 2b ELEVATE-IPF trial. This is a company announcement; there are no Phase 3 results yet and it is not approved.
United Therapeutics said the FDA accepted its application for nebulized Tyvaso (treprostinil) in IPF, based on TETON-1 and TETON-2. In the two trials combined, FVC declined 111.8 mL less than with placebo at 52 weeks. The company expects the review to finish in late April 2027. It is not approved for IPF yet.
In 257 people, a modified form of pirfenidone at 825 mg three times daily slowed the FVC drop by 91.0 mL compared with placebo over 26 weeks. Stomach side effects were the most common. A larger trial would be needed before approval.
Combining the IPF and progressive pulmonary fibrosis trials (average follow-up 16.7 months), the risk of death was 43% lower with 18 mg than with placebo. Death was a secondary endpoint, and several authors work for the drug's maker.
The European Union granted marketing authorization for Jascayd for adults with IPF or progressive pulmonary fibrosis, after a positive opinion from the EMA's committee in May.
In 598 people, FVC fell 130.1 mL less with treprostinil than with placebo at 52 weeks, and fewer had clinical worsening (31.8% vs 44.5%). There was no clear effect on flare-ups. Cough affected 54.8% vs 33.1%, and 40.5% stopped treatment vs 32.8% on placebo.
Over about 15 months, Jascayd did not lower the combined risk of a flare-up, a respiratory hospital stay or death. Deaths were numerically lower with 18 mg, but the difference was not statistically clear. About 13% to 16% of people in each group stopped because of side effects.
In 165 people with chronic cough from IPF, extended-release nalbuphine cut measured cough by 48% to 60% at 6 weeks, compared with 17% on placebo. It treats the cough, not the scarring.
In 593 people, mostly already on nintedanib or pirfenidone, FVC fell 95.6 mL less with treprostinil than with placebo at 52 weeks, and clinical worsening was less common (27.2% vs 39.0%). Cough affected 48.3% vs 24.1%.
Three approved pills slow scarring. Pulmonary rehab, oxygen and, for some people, a lung transplant make up the rest of care.
Jascayd (nerandomilast)
FDA approved
Approved Oct 7, 2025 (IPF) · Dec 19, 2025 (progressive pulmonary fibrosis) · adults
A twice-daily pill that mainly blocks an enzyme called PDE4B. In the FIBRONEER-IPF trial, it slowed the drop in FVC compared with placebo over 52 weeks, alone or with nintedanib or pirfenidone. Diarrhea was the most common side effect. The label's recommended dose is 18 mg twice daily, or 9 mg for people who can't tolerate it.
Ofev (nintedanib)
FDA approved
Approved Oct 15, 2014 · first generics approved Apr 2, 2026
In the two INPULSIS trials (1,066 people), it slowed the yearly drop in FVC by about 94 to 125 mL compared with placebo. Diarrhea affected more than 6 in 10 people taking it, but fewer than 5% stopped because of it.
Esbriet (pirfenidone)
FDA approved
Approved Oct 15, 2014 · generics approved since Jan 2022
In the ASCEND trial, it cut by 47.9% the share of people whose lung function fell sharply or who died. Stomach and skin side effects were more common than with placebo.
Inhaled treprostinil (Tyvaso)
Under FDA review
TETON-1 & TETON-2 Phase 3 · decision expected late April 2027 (company)
A nebulized drug already FDA approved for two forms of pulmonary hypertension. In both trials it slowed the drop in FVC and reduced clinical worsening over 52 weeks. Cough was the most common side effect, and more people stopped treatment than with placebo.
Pulmonary rehabilitation
Standard
Supervised exercise and education
A Cochrane review found rehab probably improves exercise ability, breathlessness and quality of life in interstitial lung disease, with benefits also likely in IPF.
Lung transplant
For some people
Serious IPF · specialist assessment
The only treatment that replaces scarred lungs. It may be an option for some people with serious IPF. The main risks are infection and the body rejecting the new lungs.
Standard treatment today
Treatment
For
What it does
Nerandomilast (Jascayd)
Adults with IPF or progressive pulmonary fibrosis
Slows lung-function decline. Can be taken alone or with nintedanib or pirfenidone.
Nintedanib (Ofev)
Adults with IPF
Slows lung-function decline.
Pirfenidone (Esbriet)
Adults with IPF
Slows lung-function decline.
Oxygen therapy
When oxygen levels are low
Eases shortness of breath and helps with exercise.
Pulmonary rehabilitation
Most people with IPF
Improves exercise ability, breathlessness and quality of life.
Lung transplant
Some people with serious IPF
Replaces the scarred lungs. Main risks are infection and rejection.
Natural remedies & daily care
No supplement has been shown to slow IPF. The daily habits with the best evidence are exercise-based rehab and not smoking. We rate each by the strength of evidence.
Strong expert consensusLimited / mixed evidenceNo evidence, or possible harm
Helpful daily care
Pulmonary rehabilitation
A Cochrane review found it is safe and probably improves exercise ability, breathlessness and quality of life in lung scarring diseases, including IPF.
Not smoking
Smoking is a common risk factor for IPF. Ask your care team for help quitting.
Oxygen when prescribed
Used to ease breathlessness and help with exercise. A Cochrane review found too few studies to judge oxygen used only during activity.
Promoted without evidence, or risky
N-acetylcysteine (NAC) supplements
In a 264-person trial, NAC did no better than placebo at protecting lung function over 60 weeks.
Prednisone + azathioprine + NAC
This once-common mix led to more deaths and hospital stays than placebo in the PANTHER-IPF trial.
Antacids or reflux surgery to treat IPF
The 2022 international guideline advises against them as a treatment for IPF itself. Reflux symptoms are a separate question for your doctor.
Be careful: breathlessness that suddenly gets much worse can be an acute flare-up of IPF. Get medical care right away. Tell your lung team before starting any supplement or new medicine, because some drugs change how IPF medicines work (Jascayd's label, for example, lists interactions with drugs that affect the liver enzyme CYP3A).
Where to get care and support
Centers recognized for expertise in this condition, and communities of people living with it.
Where people find expert care
National Jewish Health, Center for Interstitial Lung DiseaseDenver, Colorado, USA
Lists itself as a designated Pulmonary Fibrosis Foundation Care Center, with pulmonary rehabilitation, clinical trials and support groups.
Hospices Civils de Lyon, Louis Pradel Hospital (OrphaLung)Lyon, France
Coordinates France's national reference center for rare adult lung diseases, including interstitial lung diseases, set up in November 2004. It is a member of the European reference network ERN-LUNG.
These are centers recognized for expertise in this condition, not a ranking, and Cure Checker does not endorse or rate any facility. Outcomes depend on the individual. Ask your doctor which center fits your situation.
Support groups & communities
Living with a lung disease that gets worse over time is hard, and other patients and caregivers understand. Most of these are free.
Pulmonary Fibrosis Foundation support groups
Support groups
Patients · caregivers · U.S.
More than 150 in-person and virtual groups nationwide, plus monthly Zoom groups that anyone affected by pulmonary fibrosis can join without registering.
Before you join: support groups share experiences, not medical advice. Check anything about treatment with your doctor. Protect your privacy, and never share passwords or financial details. Cure Checker isn't affiliated with these groups.
How other countries treat idiopathic pulmonary fibrosis
Nintedanib and pirfenidone are approved in many countries. Jascayd has reached the U.S., China, Japan, the UK and the EU, among others, within a year.
What's available
Treatment
U.S.
EU
UK
Canada
Japan
S. Korea
China
Australia
Switz.
Nerandomilast (Jascayd)IPF and progressive pulmonary fibrosis
Approved approved for IPF (Canada: year first marketed)NICE recommended for NHS use in England; Under review: FDA application pending— not verified for this report
What's being studied abroad
International
ALOFT-IPF
Bristol Myers Squibb · admilparant (BMS-986278)
A Phase 3 trial of a twice-daily pill that blocks the LPA1 receptor, with 1,255 people enrolled. The company reported on October 12, 2026 that it met its main goal at the 60 mg dose; detailed results are still to come.
Telomerase gene changes are found in families with inherited IPF.
A common MUC5B gene variant is linked to IPF.
The FDA approves nintedanib (Ofev) and pirfenidone (Esbriet) on October 15.
The FDA approves Jascayd for IPF on October 7, and China follows on October 22. U.S. approval for progressive pulmonary fibrosis follows on December 19.
Generic nintedanib approved in the U.S. (April). Jascayd approved in Japan (May) and the EU (July). TETON trials published, and the FDA accepts the Tyvaso application (September).
What causes idiopathic pulmonary fibrosis
"Idiopathic" means the cause is unknown. The tissue around the lungs' tiny air sacs becomes thick and stiff and turns into scar tissue. The scarring seems to come from a cycle of damage and healing, but what starts it is not known.
Step 1 · The trigger
The air sacs are injured
Most often diagnosedin the 60s or 70s
Age: risk rises as people get older
Sex and smoking: more common in men, and smoking is a common risk factor
Genes: a parent or sibling with IPF raises risk, and changes in genes such as MUC5B, TERT and TERC have been linked to it
Step 2 · The tipping point
Repair goes wrong
Damage and healing repeat, and scar tissue builds up instead of normal lung
The tissue around the air sacs becomes thick and stiff
Step 3 · The damage
The lungs stiffen
Main symptoms: shortness of breath and cough
Early on: some people have no symptoms at first
Flare-ups: symptoms can suddenly become severe (an acute exacerbation)
Step 4 · The result
Lung function falls
Doctors track forced vital capacity (FVC), how much air you can blow out
Current drugs slow the yearly drop in FVC. They do not restore lost lung function
Telomere genes (Mar 29, 2007): researchers found changes in the telomerase genes TERT and TERC in about 8% of families with inherited IPF. These genes protect the ends of chromosomes, which pointed to cell aging as part of the cause.
A common gene variant (Apr 21, 2011): a variant near the MUC5B mucus gene was found in 38% of people with IPF, compared with 9% of people without it.
Suppressing the immune system backfired (May 20, 2012): in the PANTHER-IPF trial, a three-drug mix of prednisone, azathioprine and N-acetylcysteine led to more deaths and hospital stays than placebo, and that part of the trial was stopped.
Find a clinical trial
Live numbers and the newest entries from the world's main trial registries and medical databases. Most of this loads fresh each time you open the page.
Where IPF trials are recruiting right now
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Drug trials with no U.S. site
Newest published clinical trials
PubMed · U.S. National Library of Medicine
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Newest Cochrane systematic reviews
Cochrane Database of Systematic Reviews, via PubMed
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Newest trials in the EU registry
EU Clinical Trials Information System
Newest UK & international registrations
ISRCTN registry
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FDA records for the medicines in this report
Medicine
Brand
FDA application
Original approval
From Drugs@FDA via FDA's openFDA service. Some older brands are missing from FDA's open data, and newly approved drugs can take a few weeks to appear. An approval may be for a different disease than this one.
Search every registry yourself
The WHO's ICTRP gathers trials from registries worldwide, including China, Japan, India, Iran, Australia and Brazil. Cochrane CENTRAL and OpenMD don't allow automated access, so they're linked here for you to search directly.
Financial help for people living with pulmonary fibrosis
These organizations help people with pulmonary fibrosis, including IPF, pay for equipment or medicines. Funds are limited and rules vary, so contact each one directly.
Pulmonary fibrosis organizations
Pulmonary Fibrosis Trust
Equipment grants
People living with pulmonary fibrosis, or someone applying for them · United Kingdom
May fund essential equipment, such as mobility aids, where there is a real need. Trustees decide each case based on need and the charity's available money. No maximum is stated.
Insured U.S. residents with IPF · income limits apply
Helps with copays, coinsurance, deductibles and other health costs for an FDA-approved IPF treatment. On October 6, 2026 it was taking names for a waitlist, not new enrollments.
Patient Advocate Foundation TotalAssist pulmonary fibrosis fund
Copay help
People with pulmonary fibrosis on Medicare, Medicaid or TRICARE · U.S. · income limits apply
Grants toward copays, coinsurance, deductibles and insurance premiums. The fund was closed on October 6, 2026; the page lets you sign up to hear when it reopens.
Insured people with pulmonary fibrosis treated in the U.S. · income limits apply
Helps pay prescription copays for pulmonary fibrosis medicines, or Medicare Part B premiums. The fund was closed to new patients on October 6, 2026; you can sign up for alerts when it reopens.
Before you apply: Cure Checker does not run, verify or endorse these organizations, and being listed is not a promise of help. Funds are limited and rules change, so confirm eligibility and details with each organization. Be careful of anyone who asks for payment up front or for your bank login to 'release' a grant.
Sources
Everything this report is based on, grouped by section. Checked October 4, 2026.
Also cited in this block and listed above: Nerandomilast in patients with idiopathic pulmonary fibrosis (FIBRONEER-IPF, NEJM 2025), Inhaled treprostinil for idiopathic pulmonary fibrosis (TETON-2, NEJM 2026).
Not individually cited: what FVC measures and that drugs slowing FVC decline do not restore lost lung function, which reflect the established medical literature. The TETON trials were funded by United Therapeutics, and the pooled survival analysis was co-written by Boehringer Ingelheim employees. The Tyvaso review timeline is the company's own expectation. "Approved" for generic nintedanib and pirfenidone means FDA approval, not that a generic is on sale. Jascayd's Japan approval date is the date of the company's announcement. Its UK approval rests on the company's July 17, 2026 release, and we could not find the MHRA decision date. Its China approval date comes from the Drugs (Adis) profile. Canada cells show the year Health Canada lists the product as first marketed, not the approval date. Pirfenidone's approval year in Japan was not verified. All "—" cells in the approvals table are unverified. A Reddit pulmonary fibrosis community is not listed because we could not open Reddit to confirm it. The Pulmonary Fibrosis Foundation's website blocks automated access, so its support-group details come from search results of its own pages. Expert care centers: Pulmonary Fibrosis Foundation Care Center membership is confirmed through each center's own page or the Foundation's March 5, 2026 release rather than the Foundation's network list, which we could not open. Hospices Civils de Lyon is listed for its official French national reference-center designation. Financial help: checked October 6, 2026, mostly with a headless browser. All three U.S. copay funds were closed or waitlisted that day, and their status changes often. PAN Foundation's copay funds now run through Patient Advocate Foundation's TotalAssist, so PAN is not listed on its own. We found no U.S. pulmonary fibrosis charity that pays costs for individual patients: the Pulmonary Fibrosis Foundation and American Lung Association give information and point to other programs. Left out: lung-transplant fundraising platforms and drug-company programs.