News

New IPF guidelines limit treatment choices

View on the News

IPF guidelines set framework to move forward

The new IPF guidelines set a critical framework for the path forward. The international task force that formulated the 2015 update of the clinical practice guidelines for IPF have done tremendous work, moving much further toward answering the kinds of questions that the research and clinical community will not be able to address unless they work together. These guidelines are a critical appraisal of where we are and of the need to push forward.

Dr. Gregory P. Cosgrove

As we push as fast as we can toward more and better treatments, we should be aware that care of IPF patients should be multifaceted, and not just pharmacologic. In order to address the suffering associated with this disease, we need to use all available modalities: supplemental oxygen; physical therapy; and psychological support. We can help patients in so many different ways; lung fibrosis is a heterogeneous disease, and by focusing on how individual patients are affected, we can help meet their needs. The fund of available knowledge has been addressed in an evidence-based fashion. Unfortunately, this is the state of affairs; however, now we can begin to answer the questions that need to be answered.

Dr. Gregory P. Cosgrove is the chief medical officer of the Pulmonary Fibrosis Foundation and holds the endowed chair of interstitial lung disease at National Jewish Health in Denver. His comments are summarized from an interview.


 

FROM THE AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE

References

The authors of the guidelines followed a strict protocol to recuse themselves from deliberation or voting when conflicts existed. Dr. Raghu said, “The non-IPF experts were able to make unbiased recommendations.”

A patient with IPF, William Cunningham, was also a fully involved panel member, bringing his perspective into the guideline formation process. “Mr. Cunningham was incredible and he was a gentleman and a scholar. When he spoke, everyone just listened, and his input was always well thought out. He really was instrumental in the guideline-development process.” Mr. Cunningham died from his disease shortly after the committee’s work was completed. The full list of conflicts of interest and a detailed protocol description may be found in the full text of the guidelines.

koakes@frontlinemedcom.com

On Twitter @karioakes

Pages

Recommended Reading

No increased risk of lung disease with methotrexate
MDedge Rheumatology
Baseline CT scans predict lung fibrosis in SSc
MDedge Rheumatology
PAS: Mind-body practices benefit teens with chronic illnesses
MDedge Rheumatology
OARSI: Pain of knee osteoarthritis is worse for smokers
MDedge Rheumatology
ATS: Nintedanib found effective for IPF up to 76 weeks
MDedge Rheumatology
Amplified pain in knee osteoarthritis linked to insomnia, catastrophizing
MDedge Rheumatology
Is citrulline-specific ACPA key to bronchiectasis-RA link?
MDedge Rheumatology
Inspiratory muscle training boosts lung function in ankylosing spondylitis
MDedge Rheumatology
Evidence of a respiratory virus does not exclude Kawasaki disease
MDedge Rheumatology
Pneumococcal vaccination rates increase with intervention
MDedge Rheumatology