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Article History

Received: 19 May 2025

Accepted: 13 July 2025

First Online: 30 July 2025

Declarations

:

: A. Prasse reports grants or contracts from Boehringer Ingelheim, Chiesi, Novartis, Ann Theodore Foundation, GILEAD; consulting fees from Boehringer Ingelheim, MSD, paid to her institution; lecture fees from Boehringer Ingelheim, AstraZeneca, MSD paid to her institution; support for attending meeting from Boehringer Ingelheim paid to her institution; participation on a data safety monitoring board or advisory board from Boehringer Ingelheim, MSD paid to her institution; leadership or a fiduciary role in WASOG and WATL. Elisabetta A. Renzoni reports, lecture fees from Boehringer Ingelheim, Mundipharma paid to her institution; participation on a data safety monitoring or advisory board from Boehringer Ingelheim. Toby M. Maher reports personal consulting fees from Abbvie, Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, CSL Behring, Galapagos, Galectio, GlaxoSmithKline, IQVIA, Pfizer, Pliant, PureTech, Roche/Genentech, Sanofi, Theravance, Trevi and Vicore. Francesco Bonella reports personal consulting fees from Boehringer Ingelheim, Sanofi, BMS and Savara Pharma; personal lecture fees from Boehringer Ingelheim, Sanofi; personal support for attending meetings from Boehringer Ingelheim, Astra Zeneca, Atyr and Savara Pharma; personal fees for participation on a data safety monitoring or advisory board with Boehringer Ingelheim, Sanofi and BMS. W. Wuyts reports grants and fees from Boehringer Ingelheim, Hoffman la Roche, Galapagos, Alentis and Sanofi, paid to his institution. Raphael Borie reports personal consulting fees from Boehringer Ingelheim, Ferrer, Sanofi; personal lecture fees from Boehringer Ingelheim; personal support for attending meetings from Boehringer Ingelheim. Bruno Crestani reports grants from Boehringer Ingelheim; consultancy fees from BMS, Boehringer Ingelheim, Chiesi, CSL Behring, GSK, Sanofi; lecture fees from Astra Zeneca, BMS, Boehringer Ingelheim, GSK, Novartis, Roche, Sanofi; expert testimony fee from X_None; patents planned, issued or pending from X_None; participation on a data safety monitoring board or advisory board from BMS, Boehringer Ingelheim, Horizon, Sanofi; stock or stock options from X_None; receipt of equipment, materials, drugs, medical writing gifts or other services from X_None; other financial or non-financial interests from X_None and is president of the board of trustees of the Fondation du Souffle (a French charity). Johannes C. Kelder reports pro bono participation on a data safety monitoring board or advisory board from SAFE-CAB study/AMT medical. Philip L. Molyneaux reports grant funding via his institution from AstraZeneca, advisory board fees from Hoffman-La Roche, Boehringer Ingelheim, AstraZeneca, Trevi, Qureight, Endevour; speaker fees from Boehringer Ingelheim and Hoffman-La Roche, stock options from Qureight. Coline H.M. van Moorsel reports grants from the pulmonary fibrosis foundation, Boehringer Ingelheim BV and TZO grant ZonMW and a lecture fee from Boehringer Ingelheim paid to her institution Joanne J. van der Vis, Carmel J.W. Stock and J.C. Grutters have nothing to disclose.

: The medical ethical committee at each institution approved all protocols, and all patients provided written informed consent. The cohort from Belgium was obtained from the University Hospital, Leuven. The Leuven ethical committee approved this study (S63694), and written informed consent was obtained from all participants. The cohort from France was obtained from the Bichat Hospital, Paris. The CPP Ile de France 1 approved this study (0911932), and written informed consent was obtained from all participants. The Germany-1 cohort was obtained from the Ruhrlandklinik University Hospital, Essen. The local IRB (Ethik-Kommission der Medizinischen Fakultät der Universität Duisburg-Essen approved this study (20-9236-BO), and written informed consent was obtained from all participants. The Germany-2 cohort was obtained from the Hannover Medical School, Hannover. The ethic committee of Medizinische Hochschule Hannover approved this study (IRB #2518-2014 and #2923-2015), and written informed consent was obtained from all participants. The cohort from the Netherlands was obtained from the ILD center of Excellence at the St Antonius Hospital in Nieuwegein. The Medical research Ethics Committees United of St Antonius Hospital approved this study (R05-08A), and written informed consent was obtained from all participants. The UK-1 cohort was obtained from the Royal Brompton Hospital, London. The Research Ethics Committee approved this study (10/HO720/12 and 15/SC/0101), and written informed consent was obtained from all participants. The UK-2 cohort was obtained from the Royal Brompton Hospital. The NRES Committee London—Dulwich REC and The Research Ethics Committee approved this study (13/LO/0857 IRAS project ID: 125496 and 10/H0720/12), and written informed consent was obtained from all participants.

: The sponsor had no role in the design of the study, collection and analysis of the data, or the preparation of the manuscript.