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PH Information/News

Inhaled PAH Drug Maintains Walking Gains for 12 Months

Written by Ted Samson
Posted on August 19, 2026

People with pulmonary arterial hypertension (PAH) who took a once-daily investigational inhaled treatment called treprostinil palmitil inhalation powder (TPIP) maintained gains in walking distance and other health measures through 12 months, according to an ongoing study.

Although TPIP is not approved by the U.S. Food and Drug Administration (FDA), these findings are encouraging as a phase 3 trial is underway to further study its safety and effectiveness.

What Is TPIP?

TPIP is a once-daily dry-powder form of treprostinil palmitil for PAH. After it’s inhaled, treprostinil palmitil is converted into treprostinil in the lungs, where it relaxes blood vessels and helps lower pressure in the pulmonary arteries.

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PAH treatments can come in several forms, including oral, inhaled, subcutaneous, and intravenous options.

What the Study Found

The 12-month update came from a 24-month extension study that enrolled 91 people at 45 sites globally who had completed earlier TPIP studies. Some had already been taking TPIP, while others crossed over from a placebo (inactive treatment) to TPIP in the extension.

By month 12, researchers found that:

  • People who stayed on TPIP improved their six-minute walk distance by an average of 55.7 meters (about 183 feet) from their original study baseline. This test looks at how far someone can walk in six minutes.
  • People who crossed from placebo improved their walk distance by 54.1 meters from their original study baseline.
  • NT-proBNP, a blood marker of heart strain, fell by about 60 percent in both groups.
  • About 78 percent of the TPIP-continued group and 81 percent of the placebo-crossed group were in World Health Organization PH functional class 1 or 2, which means they had no symptoms or only mild limits on physical activity.

As with all treatments, TPIP may cause side effects. Researchers found that TPIP was generally well tolerated, with no newly identified safety concerns through month 12. The most common side effects included:

  • Headache
  • Cough
  • Nasopharyngitis (common cold)

Important Limits To Keep in Mind

Because there was no placebo comparison during the extension, the study can’t show cause and effect as clearly as a randomized, blinded trial.

A larger study to confirm these findings is already underway. The phase 3 PALM-PAH trial is testing once-daily TPIP against placebo in adults with PAH.

Why This Matters for People With PAH

This once-daily inhaled treatment is still in development. However, early long-term data look promising in areas that can affect everyday life, including activity level, symptom burden, and markers tied to heart strain.

At the same time, it’s too soon to know how TPIP would compare with current treatments in real-world care. The drug will need to show that it is safe and effective before it can be considered for FDA approval.

If you’re being treated for PAH and your current plan isn’t meeting your treatment goals, talk with your PAH specialist about other options. Together, you can find a plan tailored to your needs. You can also ask whether a clinical trial may be an option.

Join the Conversation

On myPHteam, people share their experiences with pulmonary hypertension, get advice, and find support from others who understand.

If a once-daily inhaled PAH treatment became available, what would matter most to you — symptom relief, convenience, side effects, or something else? Let others know in the comments below.

References
  1. Insmed Announces Positive 12-Month Data from the Ongoing Open-Label Extension Study of Treprostinil Palmitil Inhalation Powder (TPIP) in Patients With Pulmonary Arterial Hypertension — Insmed
  2. Treatments for Pulmonary Hypertension — Pulmonary Hypertension Association
  3. A Study To Evaluate the Efficacy and Safety of Once Daily Treprostinil Palmitil Inhalation Powder (TPIP) in Participants With Pulmonary Arterial Hypertension (PAH) (PALM-PAH) — ClinicalTrials.gov
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