Work

Nerandomilast‐Associated Pneumonitis With a Positive Rechallenge: A Case Report

Year: 2026

Type: article

Abstract: Nerandomilast is an oral preferential phosphodiesterase 4B inhibitor that slows the decline in forced vital capacity in idiopathic pulmonary fibrosis and progressive pulmonary fibrosis. Nerandomilast-associated pneumonitis has not previously been reported. A 33-year-old woman with advanced unclassifiable idiopathic interstitial pneumonia developed fever, dyspnoea, hypoxaemia and new bilateral consolidations and ground-glass opacities 9 days after starting nerandomilast. The drug was withdrawn, and her clinical, inflammatory and radiological findings improved during antimicrobial and corticosteroid treatment. Nerandomilast was subsequently restarted at a reduced dose. The following day, symptoms, inflammatory markers and pulmonary opacities worsened and improved again after drug withdrawal. Bronchoalveolar lavage and lung biopsy were not performed because severe chronic hypercapnia made invasive procedures unsafe. The temporal association and positive rechallenge strongly supported nerandomilast-associated pneumonitis. Clinicians should consider drug-induced pneumonitis when new pulmonary infiltrates develop after starting an antifibrotic agent.

Source: Respirology Case Reports

DOI: 10.1002/rcr2.70786

Authors: Toyoshi Yanagihara, Eriko Kinoshita, Yuuka Sakaki, Yuko Fujino, Masaki Fujita

Institution: Fukuoka University Hospital

Language: English

Topic: Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,130