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The full report is titled “Treatment of- Idiopathic Pulmonary Fibrosis With Ambrisentan. A Parallel, Randomized Trial.” It is in the 7 May 2013 issue of Annals of Internal Medicine (volume 158, pages 641-649). The authors are G. Raghu, J. Behr, K.K. Brown, J.J. Egan, S.M. Kawut, K.R. Flaherty, F.J. Martinez, S.D. Nathan, A.U. Wells, H.R. Collard, U. Costabel, L. Richeldi, J. de Andrade, N. Khalil, L.D. Morrison, D.J. Lederer, L. Shao, X. Li, P.S. Pedersen, A.B. Montgomery, J.W. Chien, T.G. O'Riordan, and the ARTEMIS-IPF Investigators.
Treatment of Idiopathic Pulmonary Fibrosis With Ambrisentan. Ann Intern Med. 2013;158:I-32. doi: 10.7326/0003-4819-158-9-201305070-00001
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Published: Ann Intern Med. 2013;158(9):I-32.
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fatal lung disease that causes irreversible scars in both lungs. There are currently no approved treatments for the disease in the United States.
In patients with IPF, a cell called a fibroblast proliferates and causes extensive scars that make it harder for oxygen to get into the bloodstream that circulates in the lungs. Ambrisentan is a drug that is known to block some of the biological effects of the fibroblasts; thus, the researchers hoped that it could decrease the formation of further scarring and improve the lung function of patients with IPF.
Patients with well-defined and well-characterized IPF aged 40 to 80 years who had computed tomography scans that showed minimal or no “honeycombing,” suggesting relatively mild IPF.
Patients with IPF were randomly assigned to receive either a 10-mg ambrisentan pill or pills that looked exactly the same but did not contain any ambrisentan (placebo pills).
The researchers were surprised and disappointed to find that patients with IPF who received ambrisentan were actually more likely to have their disease worsen and to require hospitalization than those who received placebo.
The participants in this study were a subgroup of patients with IPF who do not represent the entire population of patients with IPF. Because the patients who received ambrisentan seemed to be doing worse, the study was stopped earlier than planned; thus, the long-term effects of ambrisentan are unknown.
Patients with well-defined IPF should not be treated with ambrisentan.
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Pulmonary/Critical Care, Interstitial Lung Disease.
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