On 17 September 2025, we hosted a free masterclass on Interstitial Lung Disease (ILD). This masterclass, led by Marium Naqvi, provided an overview of key topics relating to ILD.

These topics will be covered in much more depth in our upcoming new Level 6 short course, ‘Enhancing ILD Care in Professional Practice’, which starts at the end of October. Development of this course has been supported by an independent grant from Boehringer Ingelheim. Boehringer Ingelheim have had no input into, or influence on the content or delivery of this course. 

This recording of the masterclass will be available until the end of October 2025. Underneath the recording are answers to the questions submitted via the Q&A during the session.

Q. If a patient is admitted to hospital unwell and on antifibrotics should we be stopping or pausing them if blood deranged?

A. We should stop antifibrotics if the patient is experiencing debilitating side effects that cannot be managed, including liver enzyme derangement (more than 3 x upper limit of normal).

Q. Do most of the ILD patients have restrictive lung function test results?

A. Yes. The complication is where they have co-existing lung conditions, e.g. COPD. We may not see a restrictive pattern in these cases.

Q. Would you use ICS?

A. There is no evidence to support the use of inhaled corticosteroids to manage interstitial lung disease.

Q. With the pulsed methylpred, is there a problem with giving it 3 times over 3 weeks – so patient attends as a day case and has the infusion once a week for 3 weeks instead of 3 consecutive days. Does this significantly reduce its effectiveness?

A. Yes. We are aiming to induce remission rapidly so spreading the dose over 3 weeks will not achieve this aim.

Q. In ILD fibrosis subtype do bronchodilators inhalers or other types of inhalers have any benefit to help breathlessness?

A. There is no evidence to support the use of inhalers to manage interstitial lung disease.

Q. What is “digital” clubbing?

A. Deformity of the finger/toe nails – thickening/rounding of the finger/toe and nail.