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Nerandomilast, an oral preferential phosphodiesterase 4B inhibitor with antifibrotic and immunomodulatory properties, has demonstrated efficacy in reducing forced vital capacity (FVC) decline in patients with idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) over 52 weeks. Two large phase 3, randomized, double-blind, placebo-controlled trials (FIBRONEER-IPF and FIBRONEER-ILD) showed statistically significant and clinically relevant preservation of lung function compared to placebo. Diarrhea was the most common adverse event but was generally manageable.