Where idiopathic pulmonary fibrosis treatment is heading

Idiopathic pulmonary fibrosis causes progressive scarring of the lungs with no known cause, about 30,000 to 50,000 new US diagnoses a year, mostly in older adults. Pirfenidone and nintedanib, approved in 2014, slow the disease but do not stop it. In 2025 the first new drug in over a decade (nerandomilast) was approved, and a drug built for a different lung disease (inhaled treprostinil) showed one of the strongest results yet.

• 144studies open or running
• 17phase 3 trials
• 1,535papers published this year
• 40NIH-funded projects

1. Now

   Nov 2026

   First new drug in over a decadeHappened 68.8 mL less lung function lost

   Nerandomilast slowed lung function loss by 68.8 mL over a year; approved October 2025.

   68.8 mL: less lung function lost over a year, with the higher dose.

   • FIBRONEER-IPF trial

   An inhaled drug with a large effectHappened 130.1 mL less lung function lost

   Inhaled treprostinil cut lung function loss by 130 mL and serious worsening events by a third.

   130.1 mL: less lung function lost with treprostinil over a year.

   • TETON-1 trial

   An AI-designed drug reaches patientsHappened

   A pill designed by generative AI showed early signs of slowing fibrosis in a small trial.

   • AI-discovered drug trial

2. 6 months

   by May 2027

   Nerandomilast's long-term extensionPossible

   Boehringer Ingelheim's 1,666-person extension study tracks nerandomilast's effects over several years; due April 2027.

   • FIBRONEER-IPF trial
   • FIBRONEER-ON

3. 12 months

   by Nov 2027

   A pill blocking a different scarring pathwayPossible

   Bristol Myers Squibb's admilparant (1,255 people) blocks LPA1, a different fibrosis signal; due October 2026.

   • Admilparant phase 3

4. 3 years

   by late 2029

   A gentler version of an existing drugPossible

   PureTech's deupirfenidone, a modified form of pirfenidone designed to cause fewer side effects, is compared head-to-head; due 2029.

   • SURPASS-IPF

   More AI-designed drugs in testingLong shot

   Rentosertib, another AI-discovered pill, enters a larger trial; due October 2029.

   • AI-discovered drug trial
   • Rentosertib trial

5. 5 years

   by late 2031

   A cheap diabetes pill tested for fibrosisLong shot

   A University of Massachusetts trial tests whether metformin, widely used for diabetes, slows IPF progression.

   • MAVRIC

The research paths

Borrowed from other conditions

Open to join now

• IPF

  Rentosertib (AI-designed pill)

  Phase 3 · 47 sites

  Locations and eligibility →

• IPF

  Deupirfenidone vs pirfenidone

  Phase 3 · 18 sites

  Locations and eligibility →

• IPF with chronic cough

  Nalbuphine for IPF-related chronic cough

  Phase 3 · 32 sites

  Locations and eligibility →

See every recruiting IPF trial →

When the trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

What just happened

Standard treatment today

• New diagnosisPirfenidone or nintedanib to slow decline; pulmonary rehabilitation; oxygen as needed.
• Progressing despite one drugAdding nerandomilast or switching antifibrotics; inhaled treprostinil now has strong trial support.
• Severe or end-stageLung transplant evaluation.
• Acute worsening (exacerbation)Hospital care; steroids are commonly used, though evidence for them is limited.

See IPF trials recruiting now →