Lic Form 3756 Pdf 18
Barb Magario
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Idiopathic pulmonary fibrosis (IPF) is a form of chronic interstitial lung disease of unknown cause, which predominantly affects elderly men who are current or former smokers. Even though it is an uncommon disease, it is of great importance because of its severity and poor prognosis. In recent decades, several pharmacological treatment modalities have been investigated for the treatment of this disease, and the classic concepts have therefore been revised. The purpose of these guidelines was to define evidence-based recommendations regarding the use of pharmacological agents in the treatment of IPF in Brazil. We sought to provide guidance on the practical issues faced by clinicians in their daily lives. Patients of interest, Intervention to be studied, Comparison of intervention and Outcome of interest (PICO)-style questions were formulated to address aspects related to the use of corticosteroids, N-acetylcysteine, gastroesophageal reflux medications, endothelin-receptor antagonists, phosphodiesterase-5 inhibitors, pirfenidone, and nintedanib. To formulate the PICO questions, a group of Brazilian specialists working in the area was assembled and an extensive review of the literature on the subject was carried out. Previously published systematic reviews with meta-analyses were analyzed for the strength of the compiled evidence, and, on that basis, recommendations were developed by employing the Grading of Recommendations Assessment, Development and Evaluation approach. The authors believe that the present document represents an important advance to be incorporated in the approach to patients with IPF, aiming mainly to improve its management, and can become an auxiliary tool for defining public policies related to IPF.
A fibrose pulmonar idioptica (FPI) uma forma de pneumopatia intersticial crnica fibrosante de causa desconhecida, que acomete preferencialmente homens idosos, com histria atual ou pregressa de tabagismo. Mesmo sendo uma doena incomum, ela assume grande importncia devido a sua gravidade e prognstico reservado. Nas ltimas dcadas, diversas modalidades teraputicas farmacolgicas foram investigadas para o tratamento dessa doena, de tal modo que conceitos clssicos vm sendo revisados. O objetivo destas diretrizes foi definir recomendaes brasileiras baseadas em evidncias em relao ao emprego de agentes farmacolgicos no tratamento da FPI. Procurou-se fornecer orientaes a questes de ordem prtica, enfrentadas pelos clnicos no seu cotidiano. As perguntas PICO (acrnimo baseado em perguntas referentes aos Pacientes de interesse, Interveno a ser estudada, Comparao da interveno e Outcome [desfecho] de interesse) abordaram aspectos relativos ao uso de corticosteroides, N-acetilcistena, tratamento medicamentoso do refluxo gastroesofgico, inibidores dos receptores da endotelina, inibidores da fosfodiesterase-5, pirfenidona e nintedanibe. Para a formulao das perguntas PICO, um grupo de especialistas brasileiros atuantes na rea foi reunido, sendo realizada uma extensa reviso bibliogrfica sobre o tema. As revises sistemticas com meta-anlises previamente publicadas foram analisadas quanto fora das evidncias compiladas e, a partir da, foram concebidas recomendaes seguindo a metodologia Grading of Recommendations Assessment, Development and Evaluation. Os autores acreditam que o presente documento represente um importante avano a ser incorporado na abordagem de pacientes com FPI, objetivando principalmente favorecer seu manejo, e pode se tornar uma ferramenta auxiliar na definio de polticas pblicas relacionadas FPI.
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