Comparison of recommendations in the 2015 and 2011 idiopathic pulmonary fibrosis (IPF) guidelines
| Agent | 2015 guideline | 2011 guideline |
| New and revised recommendations | ||
| Anticoagulation (warfarin) | Strong recommendation against use# | Conditional recommendation against use¶ |
| Combination prednisone + azathioprine + N-acetylcysteine | Strong recommendation against use+ | Conditional recommendation against use+ |
| Selective endothelin receptor antagonist (ambrisentan) | Strong recommendation against use+ | Not addressed |
| Imatinib, a tyrosine kinase inhibitor with one target | Strong recommendation against use# | Not addressed |
| Nintedanib, a tyrosine kinase inhibitor with multiple targets | Conditional recommendation for use# | Not addressed |
| Pirfenidone | Conditional recommendation for use# | Conditional recommendation against use¶ |
| Dual endothelin receptor antagonists (macitentan, bosentan) | Conditional recommendation against use+ | Strong recommendation against use# |
| Phosphodiesterase-5 inhibitor (sildenafil) | Conditional recommendation against use# | Not addressed |
| Unchanged recommendations | ||
| Antiacid therapy | Conditional recommendation for use¶ | Conditional recommendation for use¶ |
| N-acetylcysteine monotherapy | Conditional recommendation against use+ | Conditional recommendation against use+ |
| Anti-pulmonary hypertension therapy for IPF-associated pulmonary hypertension | Reassessment of the previous recommendation was deferred | Conditional recommendation against use¶ |
| Lung transplantation: single versus bilateral lung transplantation | Formulation of a recommendation for single versus bilateral lung transplantation was deferred | Not addressed |
#: + + + −, moderate confidence in effect estimates; ¶: + − − −, very low confidence in effect estimates; +: + + − −, low confidence in effect estimates. Reproduced from [3] with permission from the publisher.