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Home spirometry for idiopathic pulmonary fibrosis: ready for prime time?

The treatment of idiopathic pulmonary fibrosis (IPF) has been transformed with the advent of effective anti-fibrotic therapy [1]. Despite this there remain many challenges confronting those providing day-to-day care to individuals with IPF. Although IPF inevitably progresses over time, the rate at which it does so varies between individuals and is frequently punctuated by life-threatening acute exacerbations or episodes of infection. Additionally, there is currently a lack of measures for determining efficacy of anti-fibrotic treatment for individual patients, which makes decisions to change or persist with therapy difficult. From a clinical trial perspective, the successes of pirfenidone and nintedanib make the development of the next generation of treatments harder. With all future trials expected to be performed on background anti-fibrotic therapy, the rate of decline in FVC seen in trials will be less, thus reducing the window for determining the efficacy of any additional drug [2]. Home spirometry in IPF can be used to shorten clinical trials and may enable patient self-management in the future http://ow.ly/Jqft30dGiaB