We have located links that may give you full text access.
COMPARATIVE STUDY
ENGLISH ABSTRACT
JOURNAL ARTICLE
REVIEW
[Treatment of pulmonary fibrosis].
La Presse Médicale 2002 October 20
A RECENTLY MODIFIED CONCEPT: Idiopathic pulmonary fibrosis (IPF) is characterized by dyspnea on exertion, diffuse radiological infiltrates and alterations in respiratory function. The approach to IPF has recently changed with a more precise definition of the histological diagnostic criteria (hence excluding other disorders such as non-specific interstitial pneumonia), and with the hypothesis that fibro-proliferation and abnormalities in epithelial repair may have a greater physiopathological role than inflammation. DEBATABLE RESULTS FOR CORTICOSTEROIDS: To date, no treatment has demonstrated its efficacy in this disorder and few randomised studies are available. Although early observations showed some benefit of corticosteroids, it is now well established that these studies in fact included a proportion of other corticosteroid-sensitive diseases, such as non-specific interstitial pneumonia. In more recent studies, in which the diagnosis of IPF was made more rigorously, no convincing demonstration of the efficacy of corticosteroids or of immunosuppressive treatments (cyclophosphamide, azathioprine) was made. A trial of corticosteroid therapy for a period of 3 to 6 months (possibly combined with immunosuppressors) is still recommended in the absence of contraindications, but with rigorous and objective assessment of the efficacy, and careful monitoring of the side effects. TREATMENTS UNDER STUDY: Treatments aimed at limiting fibrogenesis have also been proposed. However, clinical studies have not confirmed the initial results obtained with colchicine. Nevertheless, encouraging results have been obtained with other "anti-fibrosing" agents (such as pirfenidone) or immunomodulators (interferon-gamma-1b); such treatment should be further evaluated by larger, randomised, controlled trials in order to know whether these results are applicable to a less selected population. BETWEEN SYMPTOMATIC CARE AND TRANSPLANTATION: In the absence of effective treatment, the management of IPF, the diagnosis of which has been confirmed by rigorous criteria (ideally lung biopsy) is primarily symptomatic. Young patients should be assessed with a view of pulmonary transplantation.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app