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Treprostinil Palmitil

Phase 3

Progressive Pulmonary Fibrosis | Small molecule | Respiratory |Insmed Incorporated|Trials Updated: Oct 20, 2026

Treprostinil Palmitil development status

Highest phase Phase 3
Registered trials 5 across 1 sponsor since Mar 2021

Treprostinil Palmitil target and mechanism

Molecular targetPTGIR
Target classAgonist
ModalitySmall molecule

Also known as Treprostinil Palmitil Inhalation Powder, INS1009

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials9
Total Enrollment2,125

FDA Designations

No designations recorded

Treprostinil Palmitil clinical trials

Treprostinil Palmitil · 9 trials · 5 indications

Phase 3 4Phase 2 4Phase 1 1
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 6 Minute Walk Distance (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.

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.

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 KoreaTaiwanSpainAustriaBelgiumBrazilColombiaCzechiaDenmarkFranceGeorgiaGermanyGreeceItalyMalaysiaMexicoPhilippinesPolandPortugalRomaniaSerbiaSwitzerlandTurkey (Türkiye)United Kingdom
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Recent Changes (Last 90 Days)

LOWOct 20, 2026NCT05649748lastUpdatePostDate: changed
LOWOct 20, 2026NCT05649748lastUpdatePostDate: changed
LOWOct 13, 2026NCT07179380lastUpdatePostDate: changed
LOWOct 13, 2026NCT07481981lastUpdatePostDate: changed
LOWOct 13, 2026NCT07179380lastUpdatePostDate: changed
LOWOct 13, 2026NCT07481981lastUpdatePostDate: changed
LOWSep 29, 2026NCT07179380lastUpdatePostDate: changed
LOWSep 29, 2026NCT07179380lastUpdatePostDate: changed
LOWSep 16, 2026NCT07481981lastUpdatePostDate: changed
LOWSep 16, 2026NCT07481981lastUpdatePostDate: changed
LOWSep 11, 2026NCT07643155lastUpdatePostDate: changed
LOWSep 11, 2026NCT07643155lastUpdatePostDate: changed
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

Frequently asked questions about Treprostinil Palmitil

What is Treprostinil Palmitil?

Treprostinil Palmitil is an investigational small molecule developed by Insmed Incorporated (ticker INSM) as an inhalation powder. It is being studied in hepatic impairment, progressive pulmonary fibrosis, pulmonary arterial hypertension, and pulmonary hypertension associated with interstitial lung disease. It is not approved and remains in clinical development.

What does Treprostinil Palmitil target?

Treprostinil Palmitil targets PTGIR, the prostacyclin IP receptor, and acts as an agonist. By activating this receptor, the drug is designed to mimic prostacyclin signaling in the pulmonary vasculature. This mechanism underlies its study in pulmonary hypertension and pulmonary fibrosis indications.

Who makes Treprostinil Palmitil?

Insmed Incorporated, which trades under the ticker INSM, is developing Treprostinil Palmitil. The company is running the clinical program for the inhalation powder across pulmonary and hepatic impairment indications.

What phase is Treprostinil Palmitil in?

Treprostinil Palmitil is investigational and in clinical development. Four trials are registered, with two active and two completed. The program includes Phase 3 studies in progressive pulmonary fibrosis, pulmonary arterial hypertension, and pulmonary hypertension associated with interstitial lung disease, plus a Phase 1 hepatic impairment study.

What clinical trials is Treprostinil Palmitil in?

Registered trials include NCT07805785, a Phase 3 study in progressive pulmonary fibrosis, NCT07481981, a Phase 3 study in pulmonary arterial hypertension, NCT07234032, an open-label extension in pulmonary hypertension with interstitial lung disease, and NCT07643155, a Phase 1 pharmacokinetics and safety study in hepatic impairment.

Is Treprostinil Palmitil the same as Treprostinil Palmitil Inhalation Powder?

Yes. Treprostinil Palmitil Inhalation Powder, often abbreviated TPIP, is the same investigational asset as Treprostinil Palmitil. The full name describes the inhaled powder formulation developed by Insmed Incorporated (ticker INSM) for pulmonary and hepatic impairment indications.