Skill Checkup: A 63-Year-Old Man With Persistent Cough and New Shortness of Breath

Zab Mosenifar, MD


April 21, 2022

In patients with IPF, treatment guidelines recommend nintedanib, which targets multiple tyrosine kinases, including vascular endothelial growth factor, fibroblast growth factor, and PDGF receptors. Compared with more selective tyrosine kinase inhibitors, nintedanib appears to have benefit in terms of patient-reported outcomes, including improvement in outcomes such as disease progression as measured by rate of forced vital capacity decline. However, no significant improvement in mortality has been seen.

The guidelines also advise against the use of these treatment strategies for IPF: anticoagulation (warfarin); imatinib, a selective tyrosine kinase inhibitor against PDGF receptors; combination prednisone, azathioprine, and N-acetylcysteine; and selective endothelin receptor antagonist (ambrisentan).


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