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Anti-Reflux Surgery May Help Some Patients with Idiopathic Pulmonary Fibrosis

By August 16, 2018No Comments

A clinical trial conducted in six medical centers in the United States has suggested that an operation, laparoscopic fundoplication, to treat abnormal acid gastroesophageal reflux in patients with idiopathic pulmonary fibrosis, or IPF, a fatal lung disease, may slow its progression.

paper on the clinical trial was published Aug. 9 in the medical journal The Lancet Respiratory Medicine.

Dr. Ganesh Raghu, a UW Medicine specialist in lung diseases with expertise in interstitial lung diseases, is the lead author of this pivotal study.

Raghu said, “It is clear that there is a strong association of abnormal acid reflux and IPF and the hypothesis that it may contribute to progression of disease is a longstanding one. But what is not clear is the evidence to date regarding the clinical impact of the acid gastroesophageal reflux and treatment as far as disease progression. We found that outcomes that are meaningful to patients with pulmonary fibrosis – acute exacerbation, hospitalization for respiratory problems, and deaths  – were numerically fewer within the group who had surgery compared to the group that did not receive the surgery.

“Surgery was well tolerated by the patients and was determined to be safe. The overall totality of the results was favorable and warrants further study in larger patient populations and in multicenters,” he said.

Raghu is a professor of medicine, Division of Pulmonary, Critical Care and Sleep Medicine, at the University of Washington School of Medicine in Seattle and director of UW Medicine’s Center for Interstitial Lung Disease. Raghu and his surgical colleagues at University of Washington Medical Center have been investigating the role of abnormal acid gastroesophageal reflux in patients with pulmonary fibrosis for over 20 years.

Raghu said an earlier retrospective study at UW Medical Center had documented the safety of the procedure and a trend in slowing the disease progression in patients with IPF who underwent a fundoplication. The results of this prospective randomized clinical trial confirmed those observations and thus are reassuring and encouraging.