ATS Pocket Guide 2013 - (Page 21)

1 „TREATMENT OF SELECTED COMPLICATIONS AND COMORBID CONDITIONS ■ Complications and comorbid conditions frequently associated with IPF include acute exacerbation of IPF, PH, GER, obesity, emphysema, and OSA. ■ It is unknown if treating these comorbidities influences clinical outcomes. ■ There are no data on which to make recommendations for treatment of obesity, emphysema, and OSA in the setting of IPF. Acute Exacerbation of IPF1 Recommendation: The majority of patients with acute exacerbation of IPF should be treated with corticosteroids, but corticosteroids may not be reasonable in a minority. Strength of Recommendation: Weak Quality of Evidence: ⊕ Pulmonary Hypertension1 Recommendation: PH should not be treated in the majority of patients with IPF, but treatment may be a reasonable choice in a minority. Strength of Recommendation: Weak Quality of Evidence: ⊕ Gastroesophageal Reflux Disease1 Recommendation: Asymptomatic GER disease should be medically treated in the majority of patients with IPF, but treatment may not be reasonable in a minority. Strength of Recommendation: Weak Quality of Evidence: ⊕ PALLIATIVE CARE1 ■ Palliative care should be considered an adjunct to disease-focused care. ■ Corticosteroids and thalidomide may be beneficial for chronic cough. ■ Chronic opioids may be used for severe dyspnea and cough with careful monitoring for side effects. ■ Advanced directives and end-of-life care issues should be addressed in the ambulatory setting in all patients with IPF, particularly those with severe physiologic impairment and comorbid conditions. ■ Hospice care should be considered for patients who are bedbound due to IPF. An American Thoracic Society Pocket Publication 21 

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ATS Pocket Guide 2013

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