Experts to tackle evolving therapeutic options for ILD

The treatment landscape for interstitial lung diseases (ILDs) has changed dramatically in recent years, creating new opportunities—and new challenges—for clinicians. During CHEST 2026, leading experts will explore how to navigate an expanding range of therapeutic options across several of the most common and clinically challenging fibrotic lung diseases.

“For most of ILD history, there have not been many therapies for patients, but in recent years we’ve actually developed a lot of newer therapies… it’s kind of exploded,” said Sean J. Callahan, MD, FCCP, Associate Professor in Pulmonary and Critical Care Medicine at the University of North Carolina.

Dr. Callahan will chair an engaging case-based session, Exploring Single and Combination Therapies in IPF: Better Together?, at 4 pm MST on Tuesday, October 20, in the Phoenix Convention Center. He said the goal of the session is to help clinicians determine how to prioritize, sequence, and combine therapies in real-world practice. Attendees will hear actionable guidance on matching the right patient to the right treatment strategy, setting realistic expectations, and discussing emerging treatment options with patients and their families.

“One of the really hard debates in this field is whether you start upfront therapy with multiple agents versus sequential additions, and if you do, which ones do you start with?” Dr. Callahan said.

Tessy Paul, MD, Associate Professor and Medical Director of the ILD Program at the University of Virginia, will examine the advantages and drawbacks of both approaches in patients with idiopathic pulmonary fibrosis (IPF) and provide a framework for selecting the most appropriate strategy for individual patients.

Ryan Boente, MD, Assistant Professor and Clinical Co-Director of the Interstitial Lung Disease Program at Indiana University, will discuss the complex management of hypersensitivity pneumonitis in a presentation identifying which patients are most likely to benefit from newer therapeutic approaches and how clinicians can make treatment decisions in an area where the evidence is still evolving.

One of the major controversies in this field is determining when to use immunosuppressive therapies vs newer antifibrotic agents, Dr. Callahan said. “Rather than taking a rigid position, the discussion will emphasize how to select the best option for the patient based on factors such as imaging findings, disease behavior, and individual risk profiles.”

Finally, Anthony J. Esposito, MD, FCCP, Assistant Professor of Medicine at Northwestern University, will explore the limits of immunosuppression, focusing on connective tissue disease-associated ILD, with particular attention to scleroderma-related lung disease. The presentation will focus on one of the field’s most pressing questions, according to Dr. Callahan: At what point should clinicians stop intensifying immune suppression and consider a different therapeutic approach?

“For patients who have scarring from this disease, it can be controversial when to continue immune-suppressing medications like steroids and when to transition to antifibrotic medications,” he said. 

With more treatment options at their disposal than ever before, attendees will leave the session with practical, evidence-based insights that can be immediately applied to improve decision-making and optimize outcomes for patients across the spectrum of interstitial lung diseases.

“This session will introduce attendees to pragmatic escalations of therapies in the rapidly expanding field of ILD,” Dr. Callahan said. “It will include the sequencing of antifibrotic and anti-inflammatory medications for diseases the pulmonologist commonly faces, including IPF, hypersensitivity pneumonitis, and connective tissue disease-associated ILD.”