Korean J Intern Med > Volume 41(6); 2026 > Article
REVIEW
Pulmonology
Korean J Intern Med. 2026;41(6):982-994.         doi: https://doi.org/10.3904/kjim.2026.035
Epidemiology and clinical characteristics of progressive pulmonary fibrosis in Asia
Ju Hyun Oh1,2, Felicia S. W. Teo3,4,5 , Hee-Young Yoon6, and Jin Woo Song2
1Department of Pulmonary and Critical Care Medicine, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Korea
2Department of Pulmonology and Critical Care Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
3The Lung Clinic, Mount Elizabeth Medical Centre, Mount Elizabeth Hospitals, Singapore
4Division of Respiratory & Critical Care Medicine, University Medicine Cluster, National University Hospital, Singapore
5Yong Loo Lin School of Medicine, National University of Singapore, Singapore
6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
Corresponding Author: Felicia S. W. Teo  , Tel: +65-80408210, Fax: +65 62359293, Email: drfeliciateo@thelungclinic.sg
Jin Woo Song  , Tel: +82-2-3010-3993, Fax: +82-2-3010-6968, Email: jwsongasan@gmail.com
Received: January 17, 2026;   Revised: April 10, 2026;   Accepted: July 7, 2026.
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Abstract
Progressive pulmonary fibrosis (PPF) represents a progressive phenotype across various fibrosing interstitial lung diseases (ILDs). The epidemiology of PPF is confounded by differences in the defining criteria for PPF, data capture sources, as well as the heterogeneity of ILD subtype diagnoses. In Asian PPF cohorts, although some heterogeneity exists across countries, connective tissue disease (CTD)–associated ILD is the most frequently identified underlying cause of PPF. Within CTD-ILD, rheumatoid arthritis–associated ILD and myositis-related ILD account for a particularly large proportion of patients who develop PPF. From a prognostic standpoint, PPF is consistently associated with high mortality, similar to that of idiopathic pulmonary fibrosis. Although randomized trials have demonstrated the efficacy of antifibrotic therapy in PPF, real-world use remains inconsistent because of differences in regulatory approval, reimbursement, and clinical practice. These observations underscore critical gaps in data comparability and treatment access. This narrative review synthesizes contemporary data from Asian PPF cohorts to delineate the epidemiology, clinical features, regional heterogeneity, treatment patterns, and prognosis of PPF.
Keywords: Interstitial lung disease ; Fibrosis ; Progression ; Prognosis ; Mortality

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