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Practical therapeutics


Treatment of idiopathic pulmonary fibrosis


Idiopathic pulmonary fibrosis is increasingly being diagnosed, with little improvement seen in patient prognosis. Here, we review evidence supporting the currently available options for the condition and its variants and future potential treatments


Andrew Husband, MSc, BPharm, MRPharmS Director of Education (Pharmacy) Senior Teaching Fellow, Durham University School of Medicine and Health, UK


Idiopathic pulmonary fibrosis (IPF) is the most common of a group of diseases of the lung parenchyma known as idiopathic interstitial pneumonias (IIPs). IPF is chronic and progressive, and has a very poor prognosis, with a median mortality of three years1


from diagnosis.


In recent years, there have been significant advances in diagnosis of the condition, but little progress has been made in terms of overall survival. There is an important challenge in identifying appropriate, evidence-based treatment for IPF due to a relative lack of clinical data.


Classification and epidemiology IIPs have been subject to a number of classification systems but have been most recently classified by the American Thoracic Society/European Respiratory Society multidisciplinary consensus published in 20022 Respiratory Society.


and the European


The statement divides IIPs into seven distinct groups based on histology, radiological findings and clinical presentation. These are:


● Idiopathic pulmonary fibrosis (IPF) ● Non-specific interstitial pneumonia (NSIP)


● Respiratory bronchiolitis interstitial lung disease


● Desquamative interstitial pneumonia ● Acute interstitial pneumonia ● Cryptogenic organising pneumonia ● Lymphoid interstitial pneumonia


36 www.hospitalpharmacyeurope.com


Adam Todd, PhD, MPharm, MRPharmS Senior Lecturer Pharmacy Practice & Clinical Therapeutics, Deparment of Pharmacy, University of Sunderland, UK


Lorna Clark, MSc, BSc (Hons) Pharmacy Assistant Director of Pharmacy – Clinical Services, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle, UK


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