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When to start and when to stop antifibrotic therapies.
- Source :
-
European respiratory review : an official journal of the European Respiratory Society [Eur Respir Rev] 2017 Oct 03; Vol. 26 (145). Date of Electronic Publication: 2017 Oct 03 (Print Publication: 2017). - Publication Year :
- 2017
-
Abstract
- Idiopathic pulmonary fibrosis (IPF) is characterised by progressive changes of the lung architecture causing cough and dyspnoea and ultimately leading to lung failure and death. Today, for the first time, two drugs that may reduce the inexorable progression of the disease are available, suggesting that treatment with specific drugs for IPF should be started as soon as diagnosis is made. This applies to any disease and particularly to IPF, which is marked by a 5-year survival comparable or even worse than many cancers. However, despite common sense and even worse, in spite of scientific data coming from clinical trials, post hoc analysis, long-term safety studies and real-life experiences, the question of when to start and when to stop treatment with antifibrotics is still debated. In IPF, particularly when the disease is diagnosed at an early stage, "wait and watch" behaviour is not rare to observe. This is largely due to the lack of awareness of both patients and clinicians regarding the progression of the disease and its prognosis. Another important issue is when treatment should be stopped. In general, there are two main reasons to stop a therapy: unbearable side-effects and/or lack of efficacy. According to current (although preliminary) evidence, antifibrotic drugs should not be discontinued except for safety issues.<br />Competing Interests: Conflict of interest: Disclosures can be found alongside this article at err.ersjournals.com<br /> (Copyright ©ERS 2017.)
- Subjects :
- Clinical Decision-Making
Disease Progression
Drug Administration Schedule
Early Diagnosis
Humans
Idiopathic Pulmonary Fibrosis diagnosis
Idiopathic Pulmonary Fibrosis physiopathology
Lung pathology
Lung physiopathology
Predictive Value of Tests
Respiratory System Agents adverse effects
Risk Factors
Time Factors
Treatment Outcome
Idiopathic Pulmonary Fibrosis drug therapy
Lung drug effects
Respiratory System Agents administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0617
- Volume :
- 26
- Issue :
- 145
- Database :
- MEDLINE
- Journal :
- European respiratory review : an official journal of the European Respiratory Society
- Publication Type :
- Academic Journal
- Accession number :
- 28974541
- Full Text :
- https://doi.org/10.1183/16000617.0053-2017