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Key Strategies for APPs in Fibrotic ILD Management
Managing ILDs With Fibrosis: Key Considerations for Pulmonology APPs

Released: October 27, 2025

Corey D. Kershaw
Corey D. Kershaw, MD, FCCP
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Key Takeaways
  • Interstitial lung diseases (ILDs) are often diagnosed late, and managing fibrosing ILDs can be especially challenging due to patients’ disease-specific factors and related comorbidities.
  • Multidisciplinary management of fibrosing ILDs is critical for achieving positive outcomes and should consider patients’ preferences and goals.

On Saturday, November 22, Practicing Clinicians Exchange will host its 2025 Pulmonology Playbook: Intensive for NPs and PAs. At this meeting, a colleague and I will discuss the latest advances in managing patients with interstitial lung diseases (ILDs) with fibrosis. The goals of this session are threefold. Number 1, we want to ensure advanced practice providers (APPs) can recognize fibrosing ILDs early. This is because a persistent challenge we face in pulmonology practice is that ILDs are often recognized late. In addition, healthcare professionals (HCPs) commonly struggle not just with managing patients' disease properly but with the disease-related aspects that affect their quality of life.

We hope to provide APPs with the tools needed to think about and identify ILDs with fibrosis early. This includes the beginning of the diagnostic workup that is necessary to set patients on the right path in accessing an ILD specialist. We want HCPs to feel comfortable with following some of this diagnostic process themselves and understand best practices in recognizing and diagnosing the different types of fibrosing ILDs.

Management Strategies for Fibrosing ILDs
Next, my colleague and I will discuss the ILD management strategies we employ in our practice. HCPs will learn about the currently available and FDA-approved therapies for disease-specific treatments for ILDs as well as the additional therapies that are used to treat non–idiopathic pulmonary fibrosis ILDs with fibrosis, including more traditional immunosuppression techniques.

Then we will talk about the current trends in research—from novel treatments for both IPF and ILDs, especially progressive pulmonary fibrosis, to what emerging therapies are on the horizon. Finally, we will touch on patient-directed therapy through use of shared decision-making. Although we have all these therapies to treat fibrosing ILDs, HCPs can lose sight of what matters most to patients. So, we want to ensure HCPs understand patients’ preferences and goals and know how to mitigate their symptoms, such as shortness of breath, cough, fatigue, and sleep disruption.

The Importance of Multidisciplinary Care
The final topic we will discuss is the much-needed collaborative care for patients with fibrosing ILDs. Treating these diseases does not fall upon pulmonology alone. Even the diagnosis of fibrosing ILDs requires multiple specialties, such as thoracic radiology, pathology, rheumatology, and sometimes surgery. It is important that APPs recognize that multidisciplinary care is critical in the diagnosis and management of patients with fibrosing ILDs. Partnership with these other specialties is required, as many patients have adjacent comorbidities that may affect their symptoms as much as the disease itself.

HCPs will take home best practices in engaging gastroenterology, sleep medicine, pulmonary hypertension, and palliative care experts. As much as we manage some of these comorbidities in pulmonology, sometimes symptom-directed management requires additional expertise. This is when collaborative and multidisciplinary care can be the most helpful. In particular, palliative care is especially helpful if you are struggling to manage ILDs with fibrosis and you need to start discussing end-of-life planning with patients and their caregivers.

Another key consideration regarding the multidisciplinary management of ILDs with fibrosis is determining when HCPs should consider lung transplant and refer patients. HCPs will learn what lung transplant is, what it requires, and what the outcomes are. Our hope here is that APPs will understand the many nuances of managing ILDs with fibrosis and become confident in engaging multiple specialties, as needed, to improve patients’ symptoms and quality of life.

This session will allow you to gain proficiency in these distinct areas of managing fibrosing ILDs—from diagnosis to disease-specific and comorbidity management.

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