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Lancet Respir Med. 2017 Jul;5(7):591-598. doi: 10.1016/S2213-2600(17)30219-9.

Antacid therapy in idiopathic pulmonary fibrosis: more questions than answers?

Author information

1
Department of Medicine, University of Calgary, Calgary, AB, Canada.
2
Pulmonology Department, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
3
Pulmonology Unit, Department of Thoracic Diseases, G B Morgagni L Pierantoni Hospital, Forli, Italy.
4
Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, Netherlands; Division of Heart and Lungs, University Medical Center Utrecht, Netherlands.
5
Pulmonology Department, Hospital Universitario de la Princesa, Madrid, Spain.
6
Pulmonology Department, University of Ege, Bornova-İzmir, Turkey.
7
Center for Rare Lung Diseases, University Hospital of Modena, Modena, Italy.
8
UOC Pneumologia, Università Cattolica del Sacro Cuore, Rome, Italy.
9
Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK. Electronic address: rbhild@rbht.nhs.uk.
10
Regional Referral Centre for Rare Lung Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Sicily, Italy.
11
Center for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research, Heidelberg, Germany.

Abstract

Idiopathic pulmonary fibrosis (IPF) is a progressive parenchymal lung disease of complex cause. Gastro-oesophageal reflux (GER) and microaspiration have been proposed as risk factors for the development and progression of IPF, but robust definitive data are few. A recent international guideline conditionally recommended the use of antacid therapy (proton pump inhibitors or histamine-2-receptor antagonists) for patients with IPF, in the absence of oesophageal reflux or symptoms. In this Position Paper, we summarise the literature addressing the association between GER and IPF, and also identify future research priorities that could clarify this issue. We shed light on the process through which the guideline recommendation was achieved and aim to contextualise the recommendation for providers caring for patients with IPF.

PMID:
28664861
DOI:
10.1016/S2213-2600(17)30219-9
[Indexed for MEDLINE]

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