Nerandomilast for Pulmonary Fibrosis: What Can It Do?

What does nerandomilast approval mean for pulmonary fibrosis?

The lung-disease research behind recent AI-drug longevity headlines also provides context for a separate treatment advance. While experimental rentosertib research has explored blood-based aging measurements, nerandomilast has reached regulatory approval for pulmonary fibrosis. These are different medicines with different evidence bases. The rentosertib analysis does not establish an anti-aging benefit for nerandomilast. [Nature Biotechnology analysis](https://www.nature.com/articles/s41587-026-03286-y)

On July 8, 2026, the UK's Medicines and Healthcare products Regulatory Agency approved nerandomilast for adults with idiopathic pulmonary fibrosis, or IPF, and progressive pulmonary fibrosis, or PPF. The medicine is available by prescription. This authorization concerns treatment of serious lung disease; it does not establish a role in healthy aging. [MHRA approval announcement](https://www.gov.uk/government/news/nerandomilast-jascayd-approved-to-treat-adult-patients-with-idiopathic-pulmonary-fibrosis-and-progressive-pulmonary-fibrosis)

Pulmonary fibrosis makes lung tissue stiff and scarred, progressively interfering with breathing. IPF can progress at different rates, and some patients experience sudden worsening. Preserving remaining lung function therefore matters even when a treatment cannot restore previously damaged tissue. The FDA described nerandomilast's initial IPF authorization as the first new treatment approval for that condition in more than a decade. [FDA treatment announcement](https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-drug-treat-idiopathic-pulmonary-fibrosis)

How much did nerandomilast slow lung-function decline?

The phase 3 FIBRONEER-IPF trial randomly assigned 1,177 adults to nerandomilast or placebo. Its primary measurement was forced vital capacity, or FVC: the amount of air someone can forcefully breathe out after a full breath in. At 52 weeks, adjusted average FVC fell by approximately 115 mL with nerandomilast 18 mg twice daily, compared with 184 mL with placebo. That difference was statistically significant. [FIBRONEER-IPF trial](https://www.nejm.org/doi/full/10.1056/NEJMoa2414108)

The result represents slower deterioration: average lung function still declined during treatment. Approximately 78% of participants were already taking nintedanib or pirfenidone when they enrolled, making background treatment an important part of interpreting the findings. The study was funded by Boehringer Ingelheim. Its FVC result should not be translated into a promised improvement in daily breathlessness or a specific extension of life for an individual patient. [Trial methods and results](https://www.nejm.org/doi/full/10.1056/NEJMoa2414108)

What side effects and treatment interactions matter?

Nerandomilast inhibits phosphodiesterase 4, an enzyme involved in cellular signaling. Its prescribing information lists diarrhea, reduced appetite, weight loss and nausea among common adverse reactions. Diarrhea was more frequent when nerandomilast was used alongside nintedanib. These effects can influence whether a patient can continue treatment, so tolerability deserves attention alongside lung-function measurements. [FDA prescribing information](https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/218764s002lbl.pdf)

The US label also identifies interactions with medicines that alter CYP3A activity, a pathway involved in drug metabolism. Some combinations require a different nerandomilast dose, while strong CYP3A inducers should be avoided. Pirfenidone creates additional dosing considerations. Patients should have their full medication list reviewed and contact their prescriber about persistent adverse effects before changing treatment themselves. [FDA dosing and interaction guidance](https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/218764s002lbl.pdf)