Agent | Guidance# | Strength of guidance |
Warfarin | Strong recommendation against use | Moderate confidence in effect estimates |
NAC, prednisone and azathioprine | Strong recommendation against use | Low confidence in effect estimates |
NAC monotherapy | Conditional recommendation against use | Low confidence in effect estimates |
Bosentan | Conditional recommendation against use | Low confidence in effect estimates |
Macitentan | Conditional recommendation against use | Low confidence in effect estimates |
Ambrisentan | Strong recommendation against use | Low confidence in effect estimates |
Sildenafil | Conditional recommendation against use | Moderate confidence in effect estimates |
Imatinib | Strong recommendation against use | Moderate confidence in effect estimates |
Anti-acid therapy¶ | Conditional recommendation for use | Very low confidence in effect estimates |
Nintedanib | Conditional recommendation for use | Moderate confidence in effect estimates |
Pirfenidone | Conditional recommendation for use | Moderate confidence in effect estimates |
NAC: N-acetylcysteine; #: Strong recommendation: most patients would want the suggested course of action. Conditional recommendation: the majority of patients would want the suggested course of action. Different choices will be appropriate for different patients depending on individual values and preferences. ¶: Although anti-acid therapy received a conditional recommendation for use in this guideline, this was not based on evidence from prospective randomised controlled trials. No such trials have been conducted and are needed to determine the risk–benefit ratio in patients with IPF without symptomatic gastroesophageal reflux.