TY -的T1 -在特发性pulmon三联疗法ary fibrosis: an alarming press release JF - European Respiratory Journal JO - Eur Respir J SP - 805 LP - 806 DO - 10.1183/09031936.00009112 VL - 39 IS - 4 AU - Wells, A.U. AU - Behr, J. AU - Costabel, U. AU - Cottin, V. AU - Poletti, V. Y1 - 2012/04/01 UR - //www.qdcxjkg.com/content/39/4/805.abstract N2 - On October 21, 2011, the National Heart, Lung, and Blood Institute (NHLBI), announced by press release that the prednisolone/azathioprine/N-acetylcysteine (triple therapy) arm of the PANTHER study (Prednisone, Azathioprine and N-acetylcysteine: a Study That Evaluates Response in IPF) had been discontinued [1]. Compared with patients receiving placebo, patients with idiopathic pulmonary fibrosis (IPF) treated with triple therapy had excess deaths (11% versus 1%), more hospitalisations (29% versus 8%) and a higher prevalence of serious adverse events (31% versus 9%). The study is continuing with the N-acetylcysteine and placebo arms only. No concerns have been raised as a result of preliminary analysis of the N-acetylcysteine monotherapy arm of the PANTHER study. The preliminary announcement by the NHLBI has no immediate implications with regard to the introduction or continuation of N-acetylcysteine in IPF.It is hardly surprising that this announcement has caused widespread alarm amongst medical practitioners and patients with IPF currently taking triple therapy, especially in Europe, where this therapy is largely used. In isolation, the small absolute number of excess deaths in the triple therapy arm, although statistically significant, could not be viewed as conclusive. In earlier IPF studies, the supposed efficacy of interferon-γ [2] and the protective effect of pirfenidone against acute exacerbations [3] were based on similarly low numbers of events and neither … ER -