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🌱來自: Treatment of idiopathic pulmonary fibrosis

Agents without benefit of Treatment of idiopathic pulmonary fibrosis

•Adjunctive therapies Use of empiric antireflux medications, anticoagulants, or antibiotics for the improvement of pulmonary outcomes in patients with IPF is unlikely to be beneficial based on negative results from clinical trials. (See ‘Empiric treatment for asymptomatic gastroesophageal reflux’ above and ‘Anticoagulation’ above and ‘Maintenance antibiotic therapy’ above.)

•Immunosuppressants Systemic glucocorticoid monotherapy, combination therapy with azathioprine, prednisone, and (N) acetylcysteine (NAC), monotherapy with NAC, and other broadly targeted immunosuppressants are no longer part of the routine maintenance care for patients with IPF, as there is no demonstrated efficacy, and they may be harmful. (See ‘Azathioprine, prednisone, and (N) acetylcysteine’ above and ‘(N) acetylcysteine’ above and ‘Other immunosuppressants’ above.)

•Oral pulmonary vasodilators Trials of endothelin receptor antagonists and phosphodiesterase-5 inhibitors failed to show an improvement in dyspnea or quality of life in multiple clinical trials. Although occasionally used for select patients with pulmonary hypertension otherwise out of proportion to the severity of their disease, these agents are not likely to benefit most patients with IPF. (See ‘Endothelin receptor antagonists’ above and ‘Phosphodiesterase-5 inhibitors’ above.)