Population pharmacokinetics of nerandomilast in patients with idiopathic pulmonary fibrosis and progressive pulmonary fibrosis

Megan Pane1, Curtis Johnston1∗, Rena Eudy-Byrne1, Tyler Dunlap1, Nikolas Onufrak2∗, Sonja Hartmann2∗, Steve Choy21Metrum Research Group, Boston, MA, U.S.A.,2Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, U.S.A.

∗Affiliation during time of analysis

Mechanism of Action
• Nerandomilast (JASCAYD®) is an orally administered, preferential inhibitor of the
phosphodiesterase-4B (PDE4B) isoenzyme
• PDE4B hydrolyzes and inactivates cyclic adenosine monophosphate
Therapeutic Indication
• Approved by the U.S. FDA and China’s CDE for the treatment of idiopathic pul-
monary fibrosis (IPF) and progressive pulmonary fibrosis (PPF)
• IPF is a specific type of interstitial lung disease (ILD) and PPF is associated with a
subset of ILDs distinct from IPF
• Both IPF and PPF lead to lung scarring that progresses over time, with a median
survival time of 3-5 years
Chemical and Metabolic Properties
• Nerandomilast (R-enantiomer) contains a chiral sulfoxide group and undergoes a
minor level of metabolic chiral inversion following oral administration
• The resulting S-enantiomer is pharmacologically inactive
• Both nerandomilast and the S-enantiomer were characterized in this analysis

Presented at the ASCPT 2026 Annual Meeting. An exposure-response model was developed to evaluate the effect of nerandomilast on forced vital capacity (FVC) in patients with idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) , capturing both an initial “offset effect” and a long-term “disease-modifying effect” on the rate of FVC decline. The analysis confirmed a positive exposure-response relationship that is maintained regardless of the underlying diagnosis. Furthermore, simulations support using an 18 mg twice-daily dose to mitigate the reduced drug exposure associated with background pirfenidone use, ensuring a robust treatment response for patients on multi-drug regimens.

Simulated efficacy of nerandomilast on forced vital capacity decline in idiopathic pulmonary fibrosis and progressive pulmonary fibrosis across background antifibrotic therapies Samuel P. Callisto1, Kyle Baron1, Elias Clark1, Curtis Johnston1∗, Nikolas Onufrak2∗, Sonja Hartmann2∗, Steve Choy2 1Metrum Research Group, Boston, MA, U.S.A., 2Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, U.S.A. ∗Affiliation during time of analysis Introduction.   

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