Nerandomilast treatment improves a case of progressive pulmonary fibrosis combined with severe plaque psoriasis: A case report from a clinical trial

Psoriasis (PsO) and interstitial lung disease (ILD), especially progressive pulmonary fibrosis (PPF), are often associated with abnormal immune-activation and chronic inflammation. The management of patients with PsO existing with PPF remains challenging. There is an urgent need for treatment approaches that effectively manage the progression of both diseases and minimize treatment-related risks. We report the case of a 70-year-old male patient with PsO and ILD that progressed to PPF. The patient was initially managed for PsO with methotrexate, acitretin capsules, compound glycyrrhizin tablets, total glucosides of white peony, and halometasone, but the PsO rash still recurred. Subsequently, the patient received six subcutaneous injections of adalimumab but showed no improvement in symptoms. The patient participated in the open-label extension trial (FIBRONEER-ON) with nerandomilast (BI 1015550), which was a clinical trial evaluating nerandomilast for PPF. Patient demonstrated clinical improvement in lung function with a forced expiratory volume in one second of 1.915 L and a forced vital capacity of 2.456 L with no skin lesions with active drug. To the best of our knowledge, this is the first reported case that presented the management and treatment of PsO in a patient existing with ILD progressed to PPF. The findings highlight the beneficial role of nerandomilast in the management of both PsO and PPF.