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Treprostinil Palmitil

Phase 3

Progressive Pulmonary Fibrosis | Small molecule | Respiratory |Insmed Incorporated|Last Updated: Sep 4, 2026

Target and mechanism

Molecular targetPTGIR
Target classAgonist
ModalitySmall molecule

Also known as Treprostinil Palmitil Inhalation Powder

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment800

FDA Designations

No designations recorded

Clinical trial landscape

Treprostinil Palmitil · 10 trials · 6 indications

Phase 3 4Phase 2 4Phase 1 2
NCT07805785A Study to Assess the Efficacy and Safety of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Progressive Pulmonary Fibrosis (PPF)Progressive Pulmonary Fibrosis
NOT YET_RECRUITING800 Analytics
NCT07481981A Study to Evaluate the Efficacy and Safety of Once Daily Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Arterial Hypertension (PAH)Pulmonary Arterial Hypertension
RECRUITING344 Analytics
NCT07234032An Open-Label Extension Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)Pulmonary Hypertension
RECRUITING344 Analytics
NCT07179380Efficacy and Safety Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)Pulmonary Hypertension
RECRUITING344 Analytics
PHASE3NOT YET_RECRUITING
A Study to Assess the Efficacy and Safety of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Progressive Pulmonary Fibrosis (PPF)
Progressive Pulmonary FibrosisUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Efficacy and Safety of Once Daily Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Arterial Hypertension (PAH)
Pulmonary Arterial HypertensionUnlock trial analytics
PHASE3RECRUITING
An Open-Label Extension Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)
Pulmonary HypertensionUnlock trial analytics
PHASE3RECRUITING
Efficacy and Safety Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Hypertension Associated With Interstitial Lung Disease (PH-ILD)
Pulmonary HypertensionUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in Absolute Forced Vital Capacity (FVC) at Week 52
Baseline, Week 52
Change in 6-Minute Walk Distance (6MWD) Measured at 1 to 3 Hours Post-Dose From Baseline at Week 24
Baseline, Week 24
Number of Participants Who Experienced at Least One Treatment-Emergent Adverse Events (TEAEs)
Up to 108 weeks
Change in 6MWD Measured at Peak Exposure From Baseline to Week 24
Baseline, Week 24
Number of Participants Who Experienced a Treatment Emergent Adverse Event (TEAE)
Up to approximately 25 months
Number of Participants Who Experience at Least one Treatment Emergent Adverse Event (TEAE) and TEAEs by Severity
From screening up to last follow up visit (Up to approximately 26 months)
Number of Participants Who Experience Any Number of Treatment Emergent Adverse Events (TEAEs)
Up to Day 140
Number of Participants Who Experience Any Number of Serious Adverse Events (SAEs)
Up to Day 140
Change from Baseline in Saturation of Peripheral Capillary Oxygenation (SpO2) Levels
Pre-, during, and post- 6-minute walk test (6MWT) at Baseline, Week 5, Week 10, and Week 16
Change from Baseline in Pulmonary Vascular Resistance at Week 16
Baseline to Week 16
Area Under the Concentration-Time Curve From Time Zero to Infinity (AUCinf) of Treprostinil Palmitil (TP) and Treprostinil (TRE)
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Area Under the Concentration-Time Curve From Time Zero to Last Quantifiable Concentration (AUClast) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Maximum Observed Plasma Concentration (Cmax) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Apparent Total Clearance (CL/F) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Apparent Terminal Elimination Half-Life (t1/2) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Time to Maximum Observed Concentration (Tmax) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Apparent Volume of Distribution (Vz/F) of TP and TRE
Pre-dose and at multiple timepoints post-dose up to Day 3

Determination of the effect of mild, moderate, and severe hepatic impairment on the PK of TP and TRE following a single dose of TPIP, when compared to normal hepatic function.

Parts A and B: Number of Participants who Experienced an Adverse Event (AE)
Up to Day 31 in Part A and Day 37 in Part B

Safety and tolerability of single and multiple doses of treprostinil inhalation powder will be determined in healthy participants.

Secondary Endpoints

Time to First Clinical Worsening Event
Up to 104 weeks
Time to First Acute Exacerbation of Interstitial Lung Disease (ILD)
Up to 104 weeks
Absolute Change From Baseline in Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) % Predicted Corrected for Hemoglobin at Week 52
Baseline, Week 52
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Treprostinil Palmitil Inhalation Powder (TPIP)EXPERIMENTALParticipants will receive TPIP, once daily (QD), at a starting dose of 80 micrograms (μg) to the maximum tolerated dose (up to 1280 μg) for up to 104 weeks.
PlaceboPLACEBO_COMPARATORParticipants will receive a TPIP-matching placebo, QD for up to 104 weeks.
Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants will receive TPIP, once daily (QD), at a starting dose of 80 micrograms (μg) up to maximum tolerated dose (up to 1280 μg) for 24 weeks.
Treprostinil PalmitilEXPERIMENTALParticipants will be administered TPIP once per day at a starting dose of 80 micrograms (μg). Participants will be titrated up to the highest tolerated dose for each individual participant of between 80 μg and 640 μg during the initial 3 weeks of treatment. The overall treatment period will be 16 weeks.
Group 1: Treprostinil Palmitil Inhalation PowderEXPERIMENTALHealthy participants with normal hepatic function will receive a single dose of TPIP on Day 1.
Group 2: Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants with mild hepatic impairment (classified based on the numerical Child-Pugh total score of 5 to 6) will receive a single dose of TPIP on Day 1.
Group 3: Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants with moderate hepatic impairment (classified based on the numerical Child-Pugh total score of 7 to 9) will receive a single dose of TPIP on Day 1.
Group 4: Treprostinil Palmitil Inhalation PowderEXPERIMENTALParticipants with severe hepatic impairment (classified based on the numerical Child-Pugh total score of 10 to 15) will receive a single dose of TPIP on Day 1.
Part A (SAD Cohort 1): TPIPEXPERIMENTALParticipants in the single ascending dose (SAD) Cohort 1 received a single dose of TPIP at Dose A, Dose B, or Dose C by oral inhalation on Day 1.
Part A (SAD Cohort 2): TPIP or PlaceboEXPERIMENTALParticipants in SAD Cohort 2 received a single dose of TPIP at Dose D or matching placebo by oral inhalation on Day 1.
Part A (SAD Cohort 3): TPIP or PlaceboEXPERIMENTALParticipants in SAD Cohort 3 received a single dose of TPIP at Dose E or matching placebo by oral inhalation on Day 1.
Part B (MAD Cohort 1): TPIP or PlaceboEXPERIMENTALParticipants in the multiple ascending dose (MAD) Cohort 1 received TPIP at Dose B, Dose C or matching placebo, once daily (QD) by oral inhalation on Days 1 through 7.
Part B (MAD Cohort 2): TPIP or PlaceboEXPERIMENTALParticipants in MAD Cohort 2 received TPIP up to Dose D or matching placebo, QD by oral inhalation on Days 1 through 7.

Interventions

NameTypeDescription
Treprostinil Palmitil Inhalation PowderDRUGOral inhalation using a capsule-based dry powder inhaler device.
PlaceboDRUGOral inhalation using a capsule-based dry powder inhaler device.
Treprostinil PalmitilDRUGAdministered by oral inhalation, using a Plastiape capsule-based dry powder inhaler.
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Eligibility Criteria

Age Range18 Years to 85 Years
SexALL
Healthy VolunteersNo

Inclusion Criteria: * Radiologic evidence of pulmonary fibrosis of \>10% extent on high-resolution computed tomography (HRCT) in the previous 12 months. * Diagnosis of interstitial lung disease (ILD) (other than idiopathic pulmonary fibrosis \[IPF\]) that fulfills at least 1 of the following criter...

Countries:United StatesArgentinaAustraliaIsraelJapanNew ZealandSouth KoreaSpainTaiwanAustriaBelgiumBrazilCzechiaDenmarkFranceGeorgiaGermanyGreeceItalyMalaysiaPhilippinesPortugalRomaniaSerbiaSwitzerlandTurkey (Türkiye)United KingdomMexico
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Recent Changes (Last 90 Days)

LOWSep 4, 2026NCT07805785NEW_TRIAL: changed
LOWSep 4, 2026NCT07481981lastUpdatePostDate: changed
LOWSep 4, 2026NCT07805785NEW_TRIAL: changed
LOWSep 4, 2026NCT07481981lastUpdatePostDate: changed
LOWAug 20, 2026NCT07481981startDate: changed
LOWAug 20, 2026NCT05649748lastUpdatePostDate: changed
LOWAug 20, 2026NCT07481981startDate: changed
LOWAug 20, 2026NCT05649748lastUpdatePostDate: changed
LOWAug 20, 2026NCT07481981startDate: changed
LOWAug 20, 2026NCT07481981startDate: changed
LOWAug 14, 2026NCT07234032Status: NOT_YET_RECRUITING → RECRUITING
LOWAug 14, 2026NCT07179380lastUpdatePostDate: changed
LOWAug 14, 2026NCT07234032Status: NOT_YET_RECRUITING → RECRUITING
LOWAug 14, 2026NCT07179380lastUpdatePostDate: changed
LOWAug 14, 2026NCT07234032Status: NOT_YET_RECRUITING → RECRUITING
LOWAug 11, 2026NCT07643155Status: NOT_YET_RECRUITING → RECRUITING
LOWAug 11, 2026NCT07643155Status: NOT_YET_RECRUITING → RECRUITING
LOWJul 8, 2026NCT05649748lastUpdatePostDate: changed
LOWJul 8, 2026NCT05649748lastUpdatePostDate: changed

Frequently asked questions about Treprostinil Palmitil

What is Treprostinil Palmitil used for?

Treprostinil Palmitil is an investigational small molecule being developed for pulmonary arterial hypertension (PAH) and pulmonary hypertension. It is also being studied in healthy volunteers and in people with hepatic impairment to assess safety and pharmacokinetics. The drug is formulated as an inhalation powder and is not yet approved.

What does Treprostinil Palmitil target?

Treprostinil Palmitil targets the prostacyclin receptor (PTGIR) and acts as an agonist. By activating this receptor, it is designed to produce effects relevant to treating pulmonary arterial hypertension. The drug is delivered via inhalation powder to potentially improve efficacy and safety compared with other prostacyclin therapies.

Who makes Treprostinil Palmitil?

Treprostinil Palmitil is being developed by Insmed Incorporated, a biopharmaceutical company traded on NASDAQ under the ticker INSM. Insmed is conducting clinical trials of the drug across multiple countries, including the United States, for pulmonary arterial hypertension and related conditions.

What phase is Treprostinil Palmitil in?

Treprostinil Palmitil is in Phase 1, Phase 2, and Phase 3 clinical trials. A Phase 1 study is recruiting participants with hepatic impairment, while Phase 2 studies have been completed or are active but not recruiting. A Phase 3 trial is currently recruiting patients with pulmonary arterial hypertension.

What clinical trials is Treprostinil Palmitil in?

Treprostinil Palmitil is being studied in four clinical trials. NCT07481981 is a Phase 3 trial in pulmonary arterial hypertension, NCT05649748 is a Phase 2 extension study, NCT05147805 is a completed Phase 2 trial, and NCT07643155 is a Phase 1 trial in hepatic impairment. All are controlled and double-blind.

Is Treprostinil Palmitil the same as Treprostinil Palmitil Inhalation Powder?

Yes, Treprostinil Palmitil is also known as Treprostinil Palmitil Inhalation Powder, often abbreviated as TPIP. The drug is administered as an inhalation powder and is being evaluated for pulmonary arterial hypertension. This alternative name is used in clinical trial documentation and publications.