Recommendations on treatment for IPF.
Recommendations on treatment for IPF.
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DOI：
10.1186/1465-9921-14-s1-s6
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发表时间：
2013
影响因子：
5.8
通讯作者：
Richeldi L
中科院分区：
文献类型：
--
作者：
Behr J;Richeldi L
特发性肺纤维化（IPF）的患者管理主要基于社会指南和建议。美国胸科学会（ATS）、欧洲呼吸学会（ERS）、日本呼吸学会（JRS）和拉丁美洲胸科协会（ALAT）的最新更新提供了IPF诊断和管理的最新指南，沿着了患者管理的药理学和非药理学方法建议。治疗指南基于GRADE标准，该标准根据先前发表的方法对证据质量进行评级。在这里，我们讨论如何解释最近的指南更新和临床实践的指导意义。此外，我们还讨论了过去几年临床试验的重点药物的评估和建议。尽管指南委员会没有推荐单一药物，但我们讨论了从那时起，最近的数据如何导致吡非尼酮在欧洲获得批准，以及关于由泼尼松、硫唑嘌呤和N-乙酰半胱氨酸组成的三联治疗方案的安全性的初步负面结果，提出了它是否不再是一种治疗选择的问题。作为临床医生，我们必须解释现有的指导和建议，因为我们考虑到每一个病人，因为我们讨论了现有的临床数据和病人自己的喜好，在我们的方法来管理这种疾病。
Patient management in Idiopathic Pulmonary Fibrosis (IPF) is largely based on societal guidelines and recommendations. A recent update by the American Thoracic Society (ATS), European Respiratory Society (ERS), Japanese Respiratory Society (JRS) and Latin American Thoracic Association (ALAT) provided updated guidance on the diagnosis and management of IPF, along with recommendations on pharmacologic and non-pharmacologic approaches to patient management. The treatment guidance is based on GRADE criteria, which rates the quality of evidence according to previously published methodology. Here we discuss how to interpret the recent guideline updates and the implications of this guidance for clinical practice. In addition we discuss the assessment and recommendations for a number of pharmacological agents that have been the focus of clinical trials over the past years. Although no single pharmacological agent was recommended by the guidelines committee, we discuss how since then, more recent data have resulted in the approval of pirfenidone in Europe, and preliminary negative findings regarding the safety of a triple therapy regimen consisting of prednisone, azathioprine and N-acetylcysteine have raised the question of whether it is no longer a treatment option. As clinicians, we must interpret the available guidance and recommendations as we consider each individual patient and as we discuss the available clinical data and the patient’s own preferences in our approach to the management of this disease.