JOURNAL OF THE CZECH PHARMACEUTICAL SOCIETY AND THE SLOVAK PHARMACEUTICAL SOCIETY

Čes. slov. farm. 2026, 75(1):8-13 | DOI: 10.36290/csf.2026.003

Idiopathic interstitial lung diseases - treatment options

Martina Šterclová
Pneumologická klinika 2. LF UK a FN Motol a Homolka, Pneumologická klinika 1. LF UK a FTN, Praha

Idiopathic interstitial pneumonias (IIPs) represent a heterogeneous group of rare lung diseases characterized by distinct radiological and histological phenotypes. The new 2025 classification provides a more detailed definition of individual entities, including the incorporation of idiopathic eosinophilic pneumonias and rare forms, without yet altering current therapeutic approaches. The most common form is idiopathic pulmonary fibrosis (IPF), where antifibrotic therapy with pirfenidone and nintedanib has been shown to improve prognosis. Recent clinical trials (FIBRONEER, TETON) suggest further therapeutic options. The treatment of other IIPs, particularly nonspecific interstitial pneumonia (NSIP), is based on systemic corticosteroids and immunosuppressive therapy, though evidence remains limited. Complications such as pulmonary hypertension and acute exacerbations significantly impact disease course. Non-pharmacological strategies, including oxygen therapy, pulmonary rehabilitation, and, in selected cases, lung transplantation, play an important role.

Keywords: idiopathic interstitial pneumonias, idiopathic pulmonary fibrosis, treatment, lung transplantation.

Accepted: February 19, 2026; Published: March 13, 2026  Show citation

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Šterclová M. Idiopathic interstitial lung diseases - treatment options. Čes. slov. farm. 2026;75(1):8-13. doi: 10.36290/csf.2026.003.
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References

  1. Ryerson CJ, Adegunsoye A, Piciucchi S, et al. Update of the International Multidisciplinary Classification of the Interstitial Pneumonias: An ERS/ATS Statement. Eur Respir J. 2025:2500158. Go to original source...
  2. Slabbynck K, Van Dorpe J, Peene I, et al. Endogenous Lipoid Pneumonia in Adult Autoinflammatory Disease. Arthritis Care Res (Hoboken) 2025 May 14. doi: 10.1002/acr.25570. Go to original source... Go to PubMed...
  3. Gupta R, Morgan AD, George PM, Quint JK. Incidence, prevalence and mortality of idiopathic pulmonary fibrosis in England from 2008 to 2018: a cohort study. Thorax. 2024;79(7):624-631. Go to original source...
  4. Kaul B, Lee JS, Zhang N, et al. Epidemiology of Idiopathic Pulmonary Fibrosis among U.S. Veterans, 2010-2019. Ann Am Thorac Soc. 2022;19(2):196-203. Go to original source...
  5. Maher TM, Assassi S, Azuma A, et al; FIBRONEER-ILD Trial Investigators. Nerandomilast in Patients with Progressive Pulmonary Fibrosis. N Engl J Med 2025;392(22):2203-2214. Go to original source...
  6. Richeldi L, Azuma A, Cottin V, et al; FIBRONEER-IPF Trial Investigators. Nerandomilast in Patients with Idiopathic Pulmonary Fibrosis. N Engl J Med. 2025;392(22):2193-2202. Go to original source...
  7. Oldham JM, Ma SF, Martinez FJ, et al. TOLLIP, MUC5B, and the Response to N-Acetylcysteine among Individuals with Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2015;192(12):1475-82. Go to original source...
  8. Mankikian J, Caille A, Reynaud-Gaubert M, et al; EVER-ILD investigators and the OrphaLung network. Rituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial. Eur Respir J. 2023;61(6):2202071. Go to original source...
  9. Lee SH, Park MS, Kim SY, et al. Factors affecting treatment outcome in patients with idiopathic nonspecific interstitial pneumonia: a nationwide cohort study. Respir Res. 2017;18(1):204. Go to original source...
  10. Travis WD, Hunninghake G, King TE Jr, et al. Idiopathic nonspecific interstitial pneumonia: report of an American Thoracic Society project. Am J Respir Crit Care Med. 2008;177(12):1338-47. Go to original source...
  11. Buschulte K, Kabitz HJ, Hagmeyer L, et al. Disease trajectories in interstitial lung diseases - data from the EXCITING-ILD registry. Respir Res. 2024;25(1):113. Go to original source...
  12. Flaherty KR, Wells AU, Cottin V, et al; INBUILD Trial Investigators. Nintedanib in Progressive Fibrosing Interstitial Lung Diseases. N Engl J Med 2019;381(18):1718-1727. Go to original source...
  13. Radzikowska E, Fijolek J. Update on cryptogenic organizing pneumonia. Front Med (Lausanne). 2023;10:1146782. Go to original source...
  14. Hellemons ME, Moor CC, von der Thüsen J, et al. Desquamative interstitial pneumonia: a systematic review of its features and outcomes. Eur Respir Rev 2020;29(156):190181. Go to original source...
  15. Valladares C, Narvel A, Koutsenko B, et al. Examining the Role of Corticosteroids in the Management of Acute Interstitial Pneumonia: A Systematic Review. J Clin Med Res. 2025;17(4):223-230. Go to original source...
  16. Murillo AD, Castrillon AI, Serrano CD, Fernandez-Trujillo L. Monoclonal antibodies in idiopathic chronic eosinophilic pneumonia: a scoping review. BMC Pulm Med 2024;24(1):74. Go to original source...
  17. Sergew A, Fernández Pérez ER. Current Approach to Diagnosis and Management of Pulmonary Eosinophilic Syndromes: Eosinophilic Pneumonias, Eosinophilic Granulomatosis with Polyangiitis, and Hypereosinophilic Syndrome. Semin Respir Crit Care Med. 2016;37(3):441-56. Go to original source...
  18. Lawrence A, Myall KJ, Mukherjee B, Marino P. Converging Pathways: A Review of Pulmonary Hypertension in Interstitial Lung Disease. Life (Basel). 2024;14(9):1203. Go to original source...
  19. Ang HL, Schulte M, Chan RK, et al. Pulmonary Hypertension in Interstitial Lung Disease: A Systematic Review and Meta-Analysis. Chest. 2024;166(4):778-792. Go to original source...
  20. Waxman A, Restrepo-Jaramillo R, Thenappan T, et al. Inhaled Treprostinil in Pulmonary Hypertension Due to Interstitial Lung Disease. N Engl J Med 2021;384(4):325-334. Go to original source...
  21. Waxman A, Restrepo-Jaramillo R, Thenappan T, et al. Long-term inhaled treprostinil for pulmonary hypertension due to interstitial lung disease: INCREASE open-label extension study. Eur Respir J. 2023;61(6):2202414. Go to original source...
  22. Nathan SD, Behr J, Cottin V, et al. Study design and rationale for the TETON phase 3, randomised, controlled clinical trials of inhaled treprostinil in the treatment of idiopathic pulmonary fibrosis. BMJ Open Respir Res. 2022;9(1):e001310. Go to original source...
  23. Yogeswaran A, Hassoun PM, Saleh K, et al.; PVRI-GoDeep-Consortium. Hemodynamics and Phosphodiesterase-5 Inhibitor Treatment Associated with Survival in ILD-PH: A PVRI GoDeep Meta-Registry Analysis. Am J Respir Crit Care Med. 2025. doi: 10.1164/rccm.202412-2371OC. Go to original source... Go to PubMed...
  24. Collard HR, Ryerson CJ, Corte TJ, et al. Acute Exacerbation of Idiopathic Pulmonary Fibrosis. An International Working Group Report. Am J Respir Crit Care Med. 2016;194(3):265-75. Go to original source...
  25. Kim MJ, Yang J, Song JW. Acute exacerbation of progressive pulmonary fibrosis: incidence and outcomes. Respir Res. 2024;25(1):415. Go to original source...
  26. Srivali N, De Giacomi F, Moua T, Ryu JH. Corticosteroid therapy for treating acute exacerbation of interstitial lung diseases: a systematic review. Thorax. 2025;80(3):140-149. Go to original source...
  27. Yamakawa H, Sato S, Ohta H, et al. Baricitinib for Acute Exacerbation in Idiopathic Interstitial Pneumonias: A Preliminary Study Using Propensity Score Matching. Respiration. 2025:1-12. Go to original source...
  28. Creamer AW, Barratt SL. Does ambulatory oxygen improve quality of life in patients with fibrotic lung disease? Results from the AmbOx trial. Breathe (Sheff). 2019;15(2):140-143. Go to original source...
  29. Lin LY, Wu YC, Wu JS, et al. Oxygen therapy for exercise capacity in fibrotic interstitial lung disease: A systematic review and meta-analysis of randomised controlled trials. Respir Med. 2024;227:107657. Go to original source...
  30. Khor YH, Palm A, Wong AW, et al. Effects of long-term oxygen therapy on acute exacerbation and hospital burden: the national DISCOVERY study. Thorax. 2025;80(6):378-384. Go to original source...
  31. Palm A, Ekström M. Hypoxemia severity and survival in ILD and COPD on long-term oxygen therapy - The population-based DISCOVERY study. Respir Med. 2021;189:106659. Go to original source...
  32. Özmen İ, Yildirim E, Karakiş M, et al. Are the gains from pulmonary rehabilitation the same in idiopathic pulmonary fibrosis and other interstitial lung diseases? Sarcoidosis Vasc Diffuse Lung Dis. 2024;41(3):e2024038.
  33. Zhao Q, Mo N, Li R, et al. Effects of exercise training on exercise capacity of patients with interstitial lung disease: a systematic review and meta-analysis. BMC Pulm Med. 2025;25(1):356. Go to original source...
  34. Selman M, Buendia-Roldan I, Pardo A. Decoding the complexity: mechanistic insights into comorbidities in idiopathic pulmonary fibrosis. Eur Respir J. 2025;65(5):2402418. Go to original source...
  35. Leard LE, Holm AM, Valapour M, et al. Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2021;40(11):1349-1379. Go to original source...
  36. Yang L, Xiang Z, Dai M, et al. Prognosis of Lung Transplantation in Patients with Acute Exacerbations of Interstitial Lung Disease: A Meta-Analysis Based on Cohort Studies. Ann Thorac Cardiovasc Surg. 2024;30(1):24-00086. Go to original source...
  37. Warrior K, Sayad K, O'Hara CP, Dilling DF. Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplant Outcomes. Transplantation. 2024;108(6):1460-1465. Go to original source...
  38. Dotan Y, Vaidy A, Shapiro WB, et al. Effect of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplantation Outcome. Chest. 2018;154(4):818-826. Go to original source...




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