you attend the first study visit after joining the trial and provide written consent to participate.

the study team performs a physical examination, measures vital signs such as blood pressure and heart rate, and records any use of supplemental oxygen.

a 12‑lead electrocardiogram (ecg) is taken to evaluate heart rhythm.

blood samples are collected for laboratory tests, including measurement of NT‑proBNP, a marker that reflects heart stress.

your ability to walk is tested with the six‑minute walk distance (6mwd), which records how far you can walk in six minutes.

lung function is measured with tests called forced vital capacity (fvc) and forced expiratory volume in one second (fev1).

you complete symptom questionnaires, including the lung disease questionnaire (l‑pf) and a general health survey (eq‑5d‑5l).

you are given treprostinil palmitil inhalation powder for the duration of the study.

each dose contains 1280 µg of the active ingredient and is delivered as an inhalation powder capsule.

the medication is to be inhaled according to the instructions provided by the study staff; the exact frequency (for example, once daily) will be explained at the visit.

you use the inhalation device to take the prescribed dose of treprostinil palmitil at home as instructed.

the medication is taken for up to 104 weeks (two years) unless the study is stopped early for safety reasons.

you return to the study site at scheduled intervals (for example, every 12 weeks) for safety monitoring.

each visit includes repeat measurements of vital signs, oxygen use, and a physical exam.

laboratory tests and a 12‑lead ecg are performed to check for any adverse effects.

the six‑minute walk distance test and lung function tests (fvc and fev1) are repeated to assess any changes in your condition.

blood is drawn again to measure NT‑proBNP levels.

you complete the same symptom questionnaires (l‑pf and eq‑5d‑5l) to track changes in symptoms and quality of life.

throughout the study you are asked to report any hospitalizations related to heart or lung problems, a noticeable decline in the six‑minute walk distance (15 % or more), new signs of right‑heart failure, or any need for lung transplantation.

these events are recorded as part of the study’s safety and efficacy evaluation.

at the end of the study period (up to 104 weeks) you attend a final visit where all assessments performed at baseline and during follow‑up are repeated.

the final data are used to evaluate the long‑term safety and tolerability of treprostinil palmitil inhalation powder in participants with pulmonary hypertension associated with interstitial lung disease.