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The following is a summary of “Effect of Admilparant, an LPA1 Antagonist, on Disease Progression in Pulmonary Fibrosis,” published in the April 2025 issue of the CHEST by Kreuter et al. 

Idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) are chronic, progressive interstitial lung diseases characterized by irreversible lung damage and high mortality. Admilparant (BMS-986278), an oral antagonist of the lysophosphatidic acid receptor 1 (LPA1), is currently under investigation for its potential therapeutic effects on IPF and PPF. This study aimed to evaluate the impact of admilparant on time to disease progression in patients with IPF or PPF.

This phase 2, randomized, double-blind, placebo-controlled trial included separate cohorts of patients diagnosed with IPF or PPF. Participants were randomized in a 1:1:1 ratio to receive either 30 mg or 60 mg of admilparant, or a placebo, twice daily for 26 weeks. Background antifibrotic therapies were permitted. The primary endpoint of the study was the time to disease progression, which was defined as a composite of several clinical events: a relative decline of ≥10% in percentage of predicted forced vital capacity (ppFVC), acute exacerbation, all-cause hospitalization, and all-cause mortality. Post hoc analyses examined the effect of admilparant versus placebo on this composite outcome. Additionally, subgroup analyses were performed based on the baseline median value of ppFVC. Time to the first event of disease progression over 26 weeks was assessed using the Kaplan-Meier product-limit method.

A total of 255 patients with IPF and 114 patients with PPF were enrolled in the study. The median baseline ppFVC was 77.3% in the IPF cohort and 64.7% in the PPF cohort. In both groups, treatment with 60 mg of admilparant significantly delayed disease progression compared to placebo. For patients with IPF, the disease progression was 0.54 (95% CI, 0.31–0.95), and for patients with PPF, the HR was 0.41 (95% CI, 0.18–0.90). These results were consistent across subgroups based on baseline ppFVC values, both above and below the median. In both cohorts, the most common event marking disease progression was a relative decline of ≥10% in ppFVC, and no deaths occurred as the first event of progression.

In conclusion, admilparant demonstrated a significant ability to delay disease progression in patients with both IPF and PPF over 26 weeks, suggesting its potential as a treatment option for these chronic, debilitating conditions.

Source: journal.chestnet.org/article/S0012-3692(25)00422-2/pdf