Novelty in Treatment of Pulmonary Fibrosis: Pulmonary Hypertension Drugs and Others

Michele      Correale; Antonio      Totaro; Donato      Lacedonia; Deodata      Montrone; Matteo   Di   Biase; Maria   Pia Barbaro   Foschino; Natale   Daniele   Brunetti

doi:10.2174/187152571131100086

Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic condition of unknown etiology with deteriorating respiratory function leading to respiratory failure. Corticosteroids, alone or in combination with immunosuppressive drugs such as azathioprine, colchicine, and cyclophosphamide, have been used with limited success. Interferon-gamma-1b showed a significant improvement in pulmonary function only in one study. Pirfenidone, cyclosporine and acetylcysteine may also be of benefit but data from studies are limited. Novel drugs, mainly antifibrotic, anticytokine and immunoregulatory, are currently being investigated in various trial phases. Endothelin receptor antagonists have been shown to have possible beneficial effects in early stages of IPF. However, most recently, the so-called triple combination therapy, anticoagulation therapy and endothelin receptor antagonists, especially ambrisentan, are either harmful or ineffective in IPF and are not recommended. We report a brief review on the present and possible future therapeutic options in IPF.

Keywords: Ambrisentan, bosentan, cyclophosphamide, hypertension, idiopatic pulmonary fibrosis, iloprost, pulmonary pulmonary fibrosis, pirfenidone, sildenafil.