Do you start inhaled treprostinil outside a pulmonary hypertension indication in a patient with IPF and ongoing FVC decline despite antifibrotic therapy?

The phase 3 data show efficacy with a high discontinuation rate. Of course, it's not FDA-approved, so I wouldn't start it until the FDA approves it.

At this time, initiating inhaled treprostinil purely as an antifibrotic in IPF remains challenging, given the lack of FDA approval. Off-label use faces practical barriers, including insurance coverage and cost. That said, the Phase 3 TETON data are encouraging. Both trials demonstrated a clinically meaningful reduction in FVC decline, even as add-on therapy. However, like Dr. @Dr. First Last mentioned, tolerability is a significant consideration. Drug discontinuation rates were high (34–41%). Th...