• In the video: Mette-Marit’s health “significantly worsened”

The final arguments in the trial of Marius Borg Høiby (29) will take place on Thursday, March 19, 2026. The Norwegian is the son of Crown Princess Mette-Marit (52). She hardly appeared in public anymore – most recently on Sunday afternoon. Together with Crown Prince Haakon (52), she visited Marius in Oslo prison.

Already at this point, photos from the Norwegian news portal “Se og Hør” Sparked discussions: Her face appeared softer and rounder than in previous appearances. According to experts, this may be a result of cortisone treatment.

Why treprostinil is considered hope

Regardless of the individual case, there is now general hope for those affected by the serious lung disease with a new drug: According to the study, an inhaled drug significantly slows down the progression and at the same time improves the quality of life.

This is reported by Jürgen Behr, Director of the Medical Clinic and Polyclinic V for Internal Medicine and Pulmonology at the LMU Clinic in Munich, in a recent press release.

This is the new pulmonary fibrosis drug

The drug is already known: treprostinil. So far, doctors have used it for pulmonary hypertension. It has now proven to be “effective and well tolerated,” as researchers published their results in “New England Journal of Medicine” summarize.

They “mark an important advance in the treatment of idiopathic pulmonary fibrosis – a disease that has so far been difficult to treat.” Treprostinil is administered via the respiratory tract (i.e. inhalation). It is currently not approved. But it could complement existing therapy options in the future.

Many of those affected “die after 3 to 5 years”

Mette Marit fell ill at a young age. Her health has “deteriorated significantly,” the royal court announced on Tuesday. Preparations for a possible lung transplant were initiated. This is the only life-saving therapy for those affected – and at the same time difficult because suitable donor organs are rare.

Therefore, experts are intensively researching therapies that slow down the progression of the disease and slow down the scarring of the lungs. If the respiratory organ changes in this way, it petrifies to a certain extent and becomes increasingly unable to distribute vital oxygen throughout the body. Scarring is the result of various forms of pulmonary fibrosis. This results in a poor prognosis.

“Many of the patients die within three to five years of the onset of the disease,” says Behr. The professor was currently leading the study for the drug against pulmonary fibrosis. The researchers examined the effect on patients with so-called idiopathic pulmonary fibrosis (IPF), the most common form of lung disease.

The result: “In this study, we not only found a clear positive effect on the loss of lung function, but also for the first time on the quality of life,” explains Behr, “a significant advance for the patients.”

What happens in the body with fibrosis

In fibrosis, the originally soft and stretchy lung tissue becomes hard and stiff because the connective tissue between the alveoli increases and becomes increasingly scarred. This leads to a stiffening, colloquially known as “petrification”, of the lungs. It can absorb less and less oxygen and is also increasingly unable to supply the body with oxygen.

The current study therefore sends a positive signal. Idiopathic pulmonary fibrosis (IPF) is one of the fibrotic lung diseases, also known as interstitial lung diseases (ILE), and is associated with high mortality. There are more than 200 causes of ILE. In about a third of cases, they are also accompanied by scarring of the lung tissue.

As soon as scarring (“fibrosis”) occurs, the consequences are comparable to idiopathic pulmonary fibrosis:

• increasing shortness of breath,
• dry, irritating cough,
• decreasing performance and
• Need for oxygen supply through devices.

This has been achieved with medications that significantly slow down the progression of the disease (pirfenidone and nintedanib).

If the cause is an autoimmune disease, medications are also used to slow down the excessive immune system. These include, for example, cortisone preparations – like those probably used at Mette-Marit.

In addition, doctors advise relieving the pressure on the lungs as much as possible. This includes:

• Oxygen administration
• Breathing exercises and lung sports
• Treatment of underlying diseases

Quality of life under treprostinil therapy

“Compared to previous substances,” summarizes Jürgen Behr, “this new drug promises better effectiveness with an advantageous side effect profile.” Adverse effects included coughing, for example. Behr adds that “we can get the cough under control in most patients with certain measures.”

What particularly impressed him was that the quality of life of the participants developed significantly better during the therapy than in the control group. Instead of the medication, she received an ineffective placebo during the test period.

Also relevant: A third of the participants in the group with the real medication stopped the therapy because of side effects, compared to a quarter in the control group.

Whether the drug will be approved in Germany will be decided based on the results of two further studies. These are not yet completed.