Pharmacotherapy in patients with idiopathic pulmonary fibrosis

Background: Based on the recognition of idiopathic pulmonary fibrosis as a fibroproliferative disease with the usual interstitial pneumonia histology, pharmacortherapies should be reconsidered. Objective: The aim of this study was to grasp the therapeutic efficacy of the drugs for idiopathic pulmonary fibrosis patients based on reports and the authors' own experiences. Methods: The study reviewed a spectrum of therapeutic strategies and the current problems in the drug treatments for idiopathic pulmonary fibrosis/usual interstitial pneumonia patients based on reported references. Results/conclusions: Unfortunately, the presence of usual interstitial pneumonia lesions increases the likelihood that idiopathic pulmonary fibrosis will resist various types of drug therapies. The most practical and critical points of therapeutic view are the following. First, for advanced idiopathic pulmonary fibrosis patients, small maintenance doses of drugs could reduce several adverse effects. Second, there needs to be early detection of pulmonary hypertension, which is an unfavorable prognostic factor and trial of vasodilators in patients with pulmonary hypertension. Third, for early stable patients, a large randomized controlled trial (using antifibrotic and immunomodulatory drugs) should be undertaken in order to obtain feasible results.