Fig. 1.

Ongoing challenges and unmet needs in the management of pulmonary fibrosis, and timeline of the nintedanib clinical programme to date. Except where noted, trial duration is depicted as time from enrolment of the first participant until the last visit of the last participant. a, trial of nintedanib versus placebo, shown as time from January 2013 until the last visit of the last participant [2]; b, trial of open-label nintedanib in patients who completed INPULSIS, shown as time from January 2013 until completion of data collection for the primary endpoint analysis [6]; c, trial of nintedanib versus placebo, to examine the effects of nintedanib on quantitative lung fibrosis score [7]; d, trial of add-on pirfenidone versus placebo in patients already receiving nintedanib [8]; e, trial of nintedanib versus placebo in patients with systemic sclerosis-associated interstitial lung disease [9]; f, trial to examine possible pharmacokinetic interactions between nintedanib and pirfenidone [10]; g, trial of sildenafil and nintedanib versus nintedanib alone in patients with advanced lung function impairment [11]; h, trial of nintedanib versus placebo, to examine the effects of nintedanib on concentrations of blood biomarkers for idiopathic pulmonary fibrosis [12]; i, trial of nintedanib versus placebo in patients with progressive fibrosing interstitial lung disease [13]