An analysis of three trials shows that the use of proton pump inhibitors or other antacid therapies did not seem to improve outcomes in idiopathic pulmonary fibrosis patients.

Use of proton pump inhibitors or other antacid therapies does not appear to improve outcomes in patients with idiopathic pulmonary fibrosis (IPF), and the treatment may increase infection risk in patients with advanced disease, according to findings from a post-hoc analysis of three large, randomized trials.

No significant difference in IPF disease progression was seen over a year of follow-up among patients who did and did not receive antacid treatment in the studies of the anti-fibrotic drug pirfenidone (Esbriet).

Adverse event rates were also similar between the antacid and no-antacid groups, but overall infection and pulmonary infection rates were slightly higher in patients treated with proton pump inhibitors, H2 blockers, or both, researcher Michael Kreuter, MD, of the German Center for Lung Research, Heidelberg, and colleagues wrote in Lancet Respiratory Medicine, published online March 31.

Gastroesophageal reflux disease (GERD) is common in patients with idiopathic pulmonary fibrosis, which is a chronic, irreversible, and progressive lung disease with a median survival of 2 to 3 years, the researchers wrote.

They noted that GERD is believed by many to play a role in the development and progression of IPF.

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