In patients with ILD who are started on nerandomilast on top of background nintedanib, what monitoring is most important early in therapy?

I do not use combined therapy often, and I usually stop nintedanib to start nerandomilast. This does depend on how long they've been on nintedanib. If it's within the first three months, lab monitoring as required for nintedanib is important. Otherwise, it's really just side effects. Obviously, from...

The usual suspects must be monitored closely: diarrhea, nausea, weight loss, from the clinical perspective. Because these patients are under therapy with nerandomilast, it is important to continue to be diligent with the usual laboratory testing recommended regularly for this medication: hepatic fun...

While it may seem initially that combining antifibrotics is a bad idea due to side effect profiles, it has, in fact, been done with some success. The INJOURNEY trial combined nintedanib AND perfenidone in patients with IPF, and during the study period (12 weeks), those on combined therapy lost only ...