Literature

Curbside Consults Podcast


By Clement Lee, MD, MSc

Published September 28, 2022

In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) by the American Thoracic Society (ATS). We are joined by Dr. Mary Strek, Professor of Medicine at the University of Chicago, Director of the Pulmonary Medicine Service, and Director of the Interstitial Lung Disease Program. She is also one of the guideline authors.

00:05 – Intro
00:56– Guideline process
02:20 – Overview of IPF and PPF
06:00 – Diagnosis of IPF
07:58 – Radiographic features of IPF (UIP; usual interstitial pneumonia)
10:19 – Modalities of biopsy
13:39 – Antifibrotics for the generalist
16:13 – Management of comorbidities in IPF (hypoxemia, cough)
19:25 – No role for empiric antireflux medications in IPF
21:30 – Diagnosis and management of IPF flare
24:30 – Management of PPF
26:15 – Lung transplant candidacy
28:23 – Future directions
30:44 – Concluding remarks

Articles discussed in this episode:

1. Raghu G et al. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2022.
2. King TE et al. A Phase 3 Trial of Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis. N Engl J Med 2014.
3. Richeldi L et al. Efficacy and Safety of Nintedanib in Idiopathic Pulmonary Fibrosis. N Engl J Med 2014.
4. Flaherty KR et al. Nintedanib in Progressive Fibrosing Interstitial Lung Diseases. N Engl J Med 2019.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

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Mary Strek, MD, is Professor of Medicine at the University of Chicago, Director of the Pulmonary Medicine Service, and Director of the Interstitial Lung Disease Program.
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Clement Lee, MD, MSc, was a 2021–2022 NEJM Editorial Fellow and is a 2022-2023 Senior Editorial Fellow. He is currently an internal medicine hospitalist at Newton-Wellesley Hospital and a pediatric hospitalist at Boston Children's Hospital. He completed his internal medicine-pediatrics residency at Penn-CHOP.
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