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Printable Handouts
Navigable Slide Index
- Introduction
- RCTs in IPF
- ATS/ERS international consensus statement
- Former recommendations: combination therapy
- PANTHER study: 2012
- PANTHER study results
- PANTHER study, 2014: NAC
- NAC in IPF patients: randomized trial
- PANTHER study 2014 results
- Pirfenidone
- Pirfenidone in IPF patients: a phase 3 trial
- ASCEND study
- ASCEND study design: eligibility
- ASCEND study design: HRCT
- Primary efficacy analysis of pirfenidone
- ASCEND study supportive analysis
- Pirfenidone reduces disease progression or death
- Pooled all-cause mortality
- ASCEND study: GI and skin-related events
- Nintedanib
- Efficacy and safety of nintedanib in IPF patients
- INPULSIS 1 and 2: study design
- INPULSIS study: key inclusion criteria
- Eligibility criteria based on HRCT
- INPULSIS: annual rate of decline in FVC
- Annual rate of decline in FVC by HRCT criteria
- Annual rate of decline in FVC by baseline FVC
- Time to first acute exacerbation: INPULSIS pooled
- Time to first acute exacerbation in subgroups
- Most frequent adverse events
- Linear slope of decline in FVC at week 52
- FDA approval
- ATS/ERS clinical guidelines: an update (1)
- ATS/ERS clinical guidelines: an update (2)
- Combination therapy: future of IPF management?
- A new era in IPF
- Ongoing phase 2 pharmacological trials
- Disclosures
Topics Covered
- Therapeutic options
- Management of IPF
- The ASCEND study
- INPULSIS 1 and 2 studies
Talk Citation
Richeldi, L. (2015, October 6). Diagnosis and treatment of idiopathic pulmonary fibrosis 2 [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 20, 2024, from https://doi.org/10.69645/ZQUP6045.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Luca Richeldi has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Diagnosis and treatment of idiopathic pulmonary fibrosis 2
Published on October 6, 2015
25 min
A selection of talks on Respiratory Diseases
Transcript
Please wait while the transcript is being prepared...
0:04
In terms of treatment,
it's important to recognize
the fact that
over the last decades
the community
of physicians and patients,
stakeholders in pharma companies,
they've been trying very hard
to find a cure for IPF.
In this slide,
you'll see all the randomized,
controlled trials
published so far.
Every square is a single study.
Every color is a single drug.
And the size of the square
is proportionate
to the number of patients
enrolled in that trial.
You see that
we have been very active.
Unfortunately, the vast majority
of these trials
have been negative.
So it doesn't mean
that we have given up,
because as you will see,
recently we have been
finally successful,
but it's a long story of trials.
And now we will review with you
some of these trials
to better understand
where we are
and where we have been.
What about the beginning
of these trials?
So you see before year 2000,
there were small trials,
mostly single-center,
and with different drugs
in combination.
And in those days,
there was no real engagement
from the pharmaceutical industry.
So everything was relying
on single investigators.
1:17
This is where we were
in the year 2000.
The American Thoracic Society,
together with the
European Respiratory Society
convened together
a group of experts
to provide a consensus
statement on the diagnosis
and the treatment of patients
with idiopathic
pulmonary fibrosis.
1:36
And the recommendation
that was based
mostly on these small trials
and on empirical experience
was that patients with IPF
should be treated
with a combination
of corticosteroids
and immunosuppressants,
namely azathioprine
or cyclophosphamide.
And this again was based
on the results of
small single-center trials,
but also on the belief that
inflammation and immunity
were the two major
drivers of the disease.
So since the year 2000,
this has been the recommendation
of ATS and ERS,
and these guideline
have been followed worldwide
to treat patients with IPF.