NHLBI IN THE PRESS

Surgery promising for some with idiopathic pulmonary fibrosis, but more studies needed

Researchers are reporting new evidence that surgery to prevent abnormal acid reflux appears promising for slowing the progress of idiopathic pulmonary fibrosis (IPF), an incurable disease that causes scarring of the lungs and often results in death from respiratory failure. But results of the current study, which researchers say is the first prospective controlled study addressing this link, indicate that the procedure still warrants further study before it is recommended as an effective treatment, they note.

Scientists believe that gastro-esophageal reflux—a painful condition that occurs when stomach acid flows back into the tube connecting your mouth and stomach—may play a role in the progression of IPF. In the current study, called the WRAP-IPF study, researchers studied a group of 58 patients with IPF and abnormal acid reflux. The researchers randomly assigned 29 of these patients to receive laparoscopic anti-reflux surgery and the other 29 patients to receive a normal, non-surgical treatment (anti-acid medications) for their condition.   

Nearly a year after treatment, there was no significant difference between the group that received surgery and the group that did not as measured by forced vital capacity (FVC). A test for FVC, the amount of air that can be forced from the lungs after taking the deepest breath possible, is used to determine the severity of lung diseases. However, the researchers noted that there were several encouraging improvements in the surgery group compared to the non-surgical group, including fewer respiratory-related hospital admissions and fewer deaths. Surgery appeared to be generally safe and well-tolerated among the patients who received it, but larger clinical trials are needed, they noted.

“These results are interesting and open new research questions about the morbidity associated with IPF and the mechanisms of disease exacerbation,” said James Kiley, Ph.D., director of NHLBI’s Division of Lung Diseases, in response to the findings. The study, funded by NHLBI, appears in The Lancet Respiratory Medicine.