I have written this post giving an overview of
the latest IPF guidelines.The update to the 2011 guidelines appeared in
the July 15 issue of the American Journal of Respiratory and Critical
Care Medicine. At the end I have provided download links for
the article and supplements.
Pirfenidone and Nintedanib were recommended for use in idiopathic pulmonary fibrosis (IPF) with a moderate level of confidence, in a guideline update from ATS/ERS/JRS/ALAT
It also mentions that the methods used by guideline panels to appraise
the evidence are different than those used by regulatory agencies like FDA when
they review applications seeking market approval for the use of pharmacologic
agents for treatment of IPF.
The guidline doesnot provide recommendations for one treatment
regimen over another. The guideline does not provide suggestions for or
against combination regimens or sequential therapies.
The updated
guidline has given strong recommendation against using prednisone with
azathioprine and N-acetylcysteine,The update also included strong
recommendations against use of warfarin or other anticoagulants due to
signals for harm in randomized trials in both cases. Both previously had been
suggested as not appropriate for most patients but perhaps reasonable for some.
Imatinib
and ambrisentan, not previously addressed in the guidelines, got strong
recommendations against use in IPF patients. Sildenafil is included in the
guidelines, and got a conditional recommendation against use.
The guidelines also updates on the dual endothelin receptor antagonists macitentan and bosentan , it has changed from a strong to a conditional recommendation against use.
The Lung transplantation which was not addressed in 2011 was also included but formulation of recommendation for single vs bilateral lung transplantation was deffered.
There is no change in the recommendation for anatacid therapy and N acetyl cysteine monotherapy which remains as conditional recommendation for use and conditional recommendation against use respectively.
Adverse effects were common with nintedanib therapy, particularly diarrhea, although serious adverse events were not increased and relatively few patients discontinued the drug due to adverse effects.
Pooled results from the pirfenidone trials showed more risk of
photosensitivity, fatigue, stomach discomfort, and anorexia with the drug.
I
have given the links to Download article from ATS.. Happy reading :)
2.http://www.atsjournals.org/doi/suppl/10.1164/rccm.201506-1063ST/suppl_file/raghu_data_supplement.pdf
On September 28, 2016, my partner Allen’s pulmonologist told him to go home and get his affairs in order, because he only had 30 days to live. At that time, his biopsy showed severe idiopathic pulmonary fibrosis (IPF). Allen’s IPF caused him to struggle with many common daily activities. For instance, walking just 10 feet would leave him feeling dizzy and ready to fall. He had to use a walker to get from his living room chair to the bathroom. Even on supplemental oxygen, he had no energy.
ReplyDeleteAllen began doing all the research he could on his condition and treatment options. At first, he was discouraged by the lack of information and support groups for IPF — the support groups he found were for people with COPD. Then, Allen found the multivitamincare.org website, and everything started to change for him.
After his treatment, he doesn’t need his walker to get around anymore, and he’s been able to walk short distances and exercise his legs. He still needs supplemental oxygen, but the amount he uses hasn’t increased. He’s been able to go on an Alaskan cruise with his friends without feeling like a burden. He’s also been able to travel to beaches along the Oregon coast and watch whales in the bay. He says he likes being able to go places, get out of the car and take in the sights. Before multivitamin herbal formula, he wouldn’t have been able to travel or sustain the energy for sightseeing.
Now, Allen says he feels so lucky to be alive after his doctor told him he only had 30 days left. Because of the results from his treatment, Allen has a short, sweet piece of advice for other chronic lung disease patients considering getting help from multivitamin herbal remedy.