Interstitial lung disease: a decade of progress and hope

The 10th anniversary of The Lancet Respiratory Medicine is an appropriate time to acknowledge advances in the management of interstitial lung disease (ILD) and to contemplate future directions for the field of respiratory medicine, especially for fibrotic ILD, in which developments have revolutionised both our understanding of ILD and the approach to treatment. ILDs have diverse causes and clinical presentations, making diagnosis and management challenging for clinicians. Pulmonary fibrosis, a progressive form of ILD, is characterised by inflammation and fibrosis of the lung parenchyma. 1 Raghu G Remy-Jardin M Richeldi L et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med. 2022; 205: e18-e47 Crossref PubMed Scopus (295) Google Scholar Among ILDs, idiopathic pulmonary fibrosis (IPF) is the most common and severe form, with a median survival of 3–5 years from diagnosis, emphasising the importance of ongoing research to reveal the intricacies of disease progression and improve outcomes and quality of life for people with ILD. 2 Khor YH Ng Y Barnes H Goh NSL McDonald CF Holland AE Prognosis of idiopathic pulmonary fibrosis without anti-fibrotic therapy: a systematic review. Eur Respir Rev. 2020; 29190158 Crossref Scopus (33) Google Scholar In the past decade of ILD research, numerous patient-centred achievements have transformed clinical practice and given hope to people with ILD. While acknowledging the past, we should also consider emerging research areas and unanswered questions that have the potential to further transform the field of ILD.