Ghebre Yohannes T
Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, United States.
Section of Pulmonary and Critical Care Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, United States.
Front Pharmacol. 2018 May 17;9:499. doi: 10.3389/fphar.2018.00499. eCollection 2018.
The recent FDA approval of two drugs, pirfenidone and nintedanib, for the treatment of idiopathic pulmonary fibrosis (IPF) has fueled interest in the development of additional drugs to treat the disease or its major clinical complications including cough and acute exacerbations. Since 2015, there are at least a dozen active interventional studies that are testing the efficacy of novel pharmacotherapies, exercise or stem cells in modifying the disease process in IPF. Additionally, there are combinatorial studies evaluating the effectiveness of pirfenidone or nintedanib in combination with other agents. However, there remains an urgent need for clinical trials to prospectively evaluate the efficacy of existing drugs with promising retrospective data, such as proton pump inhibitors (PPIs), in IPF. Several retrospective cohorts have provided tantalizing data supporting the beneficial effect of PPIs in patients with well-defined IPF. This review provides the general outlook of pharmacotherapies in IPF, and highlights preclinical and retrospective clinical data to make a case for randomized controlled clinical trials of PPIs in IPF.
美国食品药品监督管理局（FDA）近期批准了两种药物——吡非尼酮和尼达尼布用于治疗特发性肺纤维化（IPF），这激发了人们对研发更多治疗该疾病或其主要临床并发症（包括咳嗽和急性加重）药物的兴趣。自2015年以来，至少有十二项正在进行的干预性研究在测试新型药物疗法、运动或干细胞对改变IPF疾病进程的疗效。此外，还有一些联合研究在评估吡非尼酮或尼达尼布与其他药物联合使用的效果。然而，迫切需要进行临床试验，以前瞻性地评估现有药物（如质子泵抑制剂（PPI））在IPF中具有前景的回顾性数据的疗效。几个回顾性队列研究提供了诱人的数据，支持PPI对明确诊断的IPF患者的有益作用。本综述提供了IPF药物治疗的总体概况，并强调了临床前和回顾性临床数据，为PPI在IPF中的随机对照临床试验提供依据。
