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Guidelines Updated for Idiopathic Pulmonary Fibrosis Treatment

Panel strongly against use of anticoagulation, imatinib, endothelin receptor antagonist

WEDNESDAY, July 15, 2015 (HealthDay News) — Recommendations for idiopathic pulmonary fibrosis (IPF) treatment have been updated by an international group of respiratory societies. The updated clinical practice guideline was published in the July 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Ganesh Raghu, M.D., from the University of Washington in Seattle, and colleagues conducted systematic reviews and meta-analyses to update guidelines on IPF treatment. All relevant available evidence was assessed and discussed by a multidisciplinary panel. Conflict-of-interest management strategies were applied and non-conflicted panelists formulated, wrote, and graded recommendations.

The authors developed recommendations for or against specific treatment interventions. Updated guidelines included strong treatment recommendations against the use of anticoagulation (warfarin); imatinib; combination prednisone, azathioprine, and N-acetylcysteine; and selective endothelin receptor antagonist (ambrisentan). Conditional recommendations were for the use of nintedanib and pirfenidone, and against the use of phosphodiesterase-5 inhibitor and dual endothelin receptor antagonists. Recommendations remaining unchanged from 2011 included conditional recommendations against the use of N-acetylcysteine monotherapy and for the use of anti-acid therapy.

“Our systematic review of the available evidence on IPF treatments points to the need for additional research and long-term studies of their safety and efficacy,” Raghu said in a statement. “The guidelines empower the clinician to make the most appropriate treatment choices for the patient confronted with IPF and encourage shared decision-making with the well-informed patient to choose the most appropriate treatment options tailored to the individual patient’s needs.”

Several authors disclosed financial ties to the biopharmaceutical industry.

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