Pulmonary Fibrosis - Treatments

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How is the pulmonary fibrosis treated?

The treatment options for idiopathic pulmonary fibrosis are very limited. There is no evidence that any medications can help this condition, since scarring is permanent once it has developed. Lung transplantation is the only therapeutic option available. At times, this diagnosis can be difficult to make even with tissue biopsy reviewed by pathologists with specific experience in this field. Research trials using different drugs that may reduce fibrous scarring are ongoing.

Since some types of lung fibrosis can respond to corticosteroids (such as prednisone)or other medications that suppress the body's immune system, these types of drugs are sometimes prescribed in an attempt to decrease the processes that lead to fibrosis. These drugs do not help idiopathic pulmonary fibrosis. However, other causes of lung fibrosis may be responsive to immune suppression.

The immune system is felt to play a central role in the development of many forms of pulmonary fibrosis. The goal of treatment with immune suppressive agents such as corticosteroids is to decrease lung inflammation and subsequent scarring. Responses to treatment are variable. Once scarring has developed, it is permanent. Conditions that improve with immune suppressive treatment probably are not idiopathic pulmonary fibrosis.

The toxicity and side effects of treatments can be serious. Therefore, patients with pulmonary fibrosis should be followed by a lung specialist experienced in this condition. The lung specialist will determine the need and duration of treatment, and will monitor the response to therapy along with any side effects.

Only a minority of patients respond to corticosteroids alone, so other immune-suppressing medications are used in addition to corticosteroids. These include

  • cyclophosphamide (Cytoxan),
  • azathioprine (Imuran, Azasan),
  • methotrexate (Rheumatrex, Trexall),
  • penicillamine (Cuprimine, Depen), and
  • cyclosporine.

The anti-inflammatory medication colchicine has also been used with limited success. Other trials using drugs such as gamma interferon, mycophenolate mofetil (Cellcept), and pirfenidone have not met with much success in the treatment of idiopathic pulmonary fibrosis.

Pulmonary fibrosis causes decreased oxygen levels in the blood. A decrease in blood oxygen level (hypoxia) can lead to elevated pressure in the pulmonary artery (the vessel that carries blood from the heart to the lungs to receive oxygen), a condition known as pulmonary hypertension, which can in turn lead to failure of the right ventricle of the heart. Therefore, patients with pulmonary fibrosis are frequently treated with supplemental oxygen to prevent pulmonary hypertension. In some cases, new agents used to lower the blood pressure in the pulmonary artery have had limited benefit.

There is also evidence that patients suffering from pulmonary fibrosis may be at increased risk for blood clots that travel to the lung (pulmonary emboli), and therefore anticoagulation (blood thinning) therapy may be indicated.

Return to Pulmonary Fibrosis

See what others are saying

Comment from: DeeDee, 55-64 Female (Patient) Published: January 06

I was diagnosed in 2011 with polymyositis. I also have rheumatoid arthritis and pulmonary fibrosis. I was diagnosed in May of 2013 with the fibrosis. I was put on high doses of prednisone and methotrexate in 2011. In December 2013 I was hospitalized for 11 days with pneumonia. I am now on oxygen 24/7 and the bottom lobes of my lungs are destroyed! I have no idea how long I have to live but I am going for a stem cell procedure. They have had 70-75% success rate! This gives me great hope it will slow the progression!

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Comment from: Fastforwardmd, 65-74 Male (Patient) Published: May 30

I was diagnosed with usual interstitial pneumonia (UIP) 2.5 years ago but was suffering the symptoms for three years before that. My dad had it too but the doctors did not pay attention because he was suffering from throat cancer and he was in his late 80s. The last 13 years of his life I lived with him. Our house was near a creek and therefore there were many run-ins with rats, rat feces and urine. I am personally convinced that it was this contact that caused our pulmonary fibrosis. I am up to 10 liters when I move around on my oxygen concentrator but I can sleep with it set at 7 liters. They say I will probably contract pneumonia and will die from that. I have installed 2 HEPA filters in my apartment and they are keeping me from catching pneumonia. I took prednisone for thirty days and that rid me of my arthritis symptoms but did nothing but make me susceptible to pneumonia. I don"t take any pills now for 2.5 years. I don"t want to be a guinea pig suffering side effects. I have no idea how I am going to die. Aim confined to the apartment and my oxygen concentrator.

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