title: Evidence-based treatment strategies in idiopathic pulmonary fibrosis.
abstract: Recently updated guidelines have provided revised recommendations, based on the GRADE criteria, for the diagnosis and pharmacological and non-pharmacological management of patients with idiopathic pulmonary fibrosis (IPF). Cochrane reviews are also a highly respected and reliable source of evidence-based information that identify and analyse all available data of overall treatment effects from appropriate studies. A recent update of one Cochrane review failed to identify any new evidence supporting the use of corticosteroids in IPF. Another review of data from 15 randomised controlled studies of non-steroid agents for the treatment of IPF identified two trials of interferon-γ-1b suitable for analysis. However, the pooled analysis revealed no treatment effect in terms of survival. A further meta-analysis of three phase III studies of pirfenidone treatment in IPF patients suggested a significant increase in progression-free survival. The interpretation of recent international and national European guideline updates and treatment recommendations, available clinical data from published and ongoing trials investigating potential pharmacological agents, and the individual patient's preferences, must be considered in the clinical management of this disease.
authors.affiliation: Asklepios Fachkliniken München Gauting, Dept of Internal Medicine V, Comprehensive Pneumology Center, University of Munich, Munich, Germany. Juergen.behr@med.uni-muenchen.de
authors.forename: Jürgen
authors.initials: J
authors.lastname: Behr
mesh_terms: D018572:Disease-Free Survival; D019317:Evidence-Based Medicine; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cochrane; evidence based; guidelines; idiopathic pulmonary fibrosis; pirfenidone; treatment recommendations