BackgroundIdiopathic pulmonary fibrosis (IPF) is a disease with significant morbidity and mortality. Patients short survival time, high mortality and generally rapid decline raise the importance of early treatment. Current guidelines suggest a combination of corticosteroids and immunosuppressants as "gold standard" for IPF treatment, although the evidence for this recommendation is weak. Based on animal models, it has been hypothesized a central role for aberrant wound healing following repeated epithelial lung injury, weakening the rationale for using corticosteroids in IPF, previously thought to be a chronic inflammatory disease. ObjectivesThe aim of the review is to determine the e icacy of corticosteroids in the treatment of adults with familial and sporadic IPF.

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Cochrane Database of Systematic Reviews Authors' conclusions Methotrexate may have a small steroid sparing e ect in adults with asthma who are dependent on oral corticosteroids. However, the overall reduction in daily steroid use is probably not large enough to reduce steroid-induced adverse e ects. This small potential to reduce the impact of steroid side-e ects is probably insu icient to o set the adverse e ects of methotrexate.

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