10 Dec Idiopathic Pulmonary Fibrosis: Co-trimoxazole Therapy Did Not Prevent Disease Progression
MedicalResearch.com Interview with:
Andrew M. Wilson, MD
Clinical Senior Lecturer in Respiratory Health
University of East Anglia
Norwich and Honorary Consultant Physician in Respiratory Medicine
Norfolk and Norwich University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Idiopathic pulmonary fibrosis has a poor prognosis and limited treatment options. Clinical trial evidence suggested a survival benefit for people taking co-trimoxazole and microbiological data suggested that infection was implicated in prognosis. However this large multicentre study did not show that co-trimoxazole had an beneficial effect in terms of time to all-cause mortality, hospitalisation or lung transplant in people with moderate and severe idiopathic pulmonary fibrosis
MedicalResearch.com: What should readers take away from your report?
Response: Co-trimoxazole should not be given on a prophylactic basis with an aim to prevent disease progression.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research is required to explore different subgroups of individuals, for example those with extensive traction bronchiectasis. In addition, there was a suggestion that co-trimoxazole improved cough and further studies would be required before that was confirmed.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: Patients should still receive therapeutic antibiotics as required for respiratory tract infection. This was funded by National Institute for Health Research Efficacy and Mechanism Evaluation Programme Grant number 12/206/09
Wilson AM, Clark AB, Cahn T, et al. Effect of Co-trimoxazole (Trimethoprim-Sulfamethoxazole) vs Placebo on Death, Lung Transplant, or Hospital Admission in Patients With Moderate and Severe Idiopathic Pulmonary Fibrosis: The EME-TIPAC Randomized Clinical Trial. JAMA. 2020;324(22):2282–2291. doi:10.1001/jama.2020.22960
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