Individual research recommendation details

Recommendation ID

CG163/5

Question

Anti-reflux therapy as a treatment for idiopathic pulmonary fibrosis:- Is anti-reflux therapy an effective treatment for idiopathic pulmonary fibrosis?

Any explanatory notes
(if applicable)

Why this is important:- There is evidence from observational studies, and uncontrolled interventional trials, that microaspiration of gastric/oesophageal contents contribute to disease progression, and perhaps even cause idiopathic pulmonary fibrosis. There have been no randomised controlled trials of anti-reflux therapy in idiopathic pulmonary fibrosis but proton-pump inhibitors are often prescribed for symptoms of acid-reflux. A randomised, placebo-controlled trial of adequate power and duration of greater than 12 months should be undertaken to determine the benefits and side effects of anti-reflux therapy, including proton pump inhibition in people with a confirmed diagnosis of idiopathic pulmonary fibrosis. Appropriate end points may include mortality (allcause and idiopathic pulmonary fibrosis-related); hospitalisation (all-cause, non-elective and idiopathic pulmonary fibrosis-related); lung function (vital capacity and diffusion capacity for carbon monoxide); 6-minute walk distance; breathlessness score; a measure of health-related quality of life (ideally employing a tool validated in idiopathic pulmonary fibrosis patients). Phase III trials should include a health economic evaluation.

Source guidance details

Comes from guidance

Idiopathic pulmonary fibrosis in adults: diagnosis and management

Number

CG163

Date issued

June 2013

Other details