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Article History

Received: 16 December 2025

Accepted: 2 May 2026

First Online: 17 June 2026

Declarations

Ethics approval and consent to participate: This study will be performed according to the principles of the Declaration of Helsinki and in accordance with the Medical Research Involving Human Subjects Act. This study is exempt from ethics, as approved by the IRB Medical Ethics Committee (METC) of Erasmus Medical Center, Rotterdam, the Netherlands, with the protocol reference number MEC-2024-0045, date of approval: 23-05-2024. Approval from the Medical Ethics Committee of all participating sites is also obtained. Written informed consent will be obtained from all participants.

Consent for publication: Not applicable.

Competing interests: DH: Support for the present study from ZonMw / the Netherlands Organisation for Health Research and Development paid to institution. CM: Support for the present study from ZonMw / the Netherlands Organisation for Health Research and Development, grants outside the submitted work from Boehringer-Ingelheim and Astra-Zeneca-Daiichi Sankyo paid to institution, payments for presentations/lectures from Boehringer-Ingelheim and GSK paid to institution, support for travel from Boehringer-Ingelheim paid to institution, and leadership roles with the ERS Early Career Member Committee, Early Career Member Representative of the ILD Assembly, Professional Advisory Committee European Lung Foundation, and Advocacy Council ERS. FvB: No disclosures to report. AV: No disclosures to report. MO: No disclosures to report. KvD: No disclosures to report. LM: No disclosures to report. JvdM: No disclosures to report. PB: No disclosures to report. DL: Support for travel from Boehringer-Ingelheim and board member of the section ILD Dutch Society for Chest physicians (NVALT). ES: No disclosures to report. RK: No disclosures to report. PvdW: No disclosures to report. MdM: No disclosures to report. RM: Grants outside the submitted work from the Dutch pulmonary fibrosis patient society and Boehringer-Ingelheim paid to institution, payment or honoraria for presentations from GSK, Boehringer-Ingelheim, Astra-Zeneca, and Johnson & Johnson, participation on a data safety monitoring board from Boehringer-Ingelheim, and member of the executive committee WASOG up to 2024, Dutch asbestosis expert panel, board member section ILD Dutch Society for Chest physicians (NVALT) up to 2023, advisory board for the Dutch pulmonary fibrosis patient society, and President Regional Central Educational Committee OORZON. MW: Support for the present study from ZonMw / the Netherlands Organisation for Health Research and Development paid to institution, grants outside the submitted work from Astra-Zeneca-Daiichi Sankyo, Boehringer-Ingelheim, Erasmus MC, Hoffmann-La Roche, Sarcoidosis.nl, The Dutch Lung Foundation, The Dutch Pulmonary Fibrosis Patients Association, The Netherlands Organization for Health Research and Development, The Thorax Foundation paid to institution, consulting fees from Astra-Zeneca-Daiichi Sankyo, Avalyn Pharma, Boehringer-Ingelheim, Bristol-Myers Squibb, CSL Behring, Galapagos, Galecto, GlaxoSmithKline, Hoffmann-La Roche, Horizon Therapeutics, Kinevant Sciences, Molecure, NeRRe Therapeutics, Novartis, PureTech Health, Trevi, and Vicore outside submitted work paid to institution, payment or honoraria for presentations from Avalyn Pharma, Boehringer-Ingelheim, Sanofi, CSL Behring, and Novartis, support for travel from Boehringer-Ingelheim, GSK, and Hoffmann-La Roche, and leadership roles as secretary of ILD assembly for European Respiratory Society, Board member of the Netherlands Respiratory Society, Scientific advisory board of European idiopathic pulmonary fibrosis and related disorders federation, chair of educational committee of European Reference Network for Rare Lung Diseases, and advisory board of Dutch lung fibrosis and sarcoidosis patient associations.