Drug development in interstitial lung diseases has traditionally focused on individual conditions such as IPF or connective tissue disease–associated ILD. However, increasing evidence suggests that many ILDs converge on shared fibrotic pathways. As PPF has emerged as a cross-disease construct to enable trial design, this raises a critical question: are we building therapies for diseases, or for fibrosis itself?

Key Discussion Points:

• What is best disease vs phenotype-driven development? Should therapies be developed for individual ILDs, or for fibrotic progression across diseases through constructs like PPF?
• How indication strategy influence trial design from patient stratification, endpoint selection, and the likelihood of detecting meaningful treatment effects
• Navigating the regulatory and commercial realities of broader indications vs disease-specific labels for approval, positioning, and reimbursement
• As shared fibrotic biology becomes clearer, should drug development move toward mechanism-based approaches rather than traditional disease categories?