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Idiopathic Pulmonary Fibrosis — RACP Adult Medicine MCQ

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ModerateRespiratoryIdiopathic Pulmonary FibrosisRACP Adult Medicine

A 72-year-old man with known idiopathic pulmonary fibrosis (IPF) has a progressive decline in FVC of 10% over 6 months. His current FVC is 62% predicted and DLCO is 38% predicted. What is the most appropriate pharmacological management?

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Correct answer: D — Nintedanib 150 mg BD

Antifibrotic agents (nintedanib or pirfenidone) are the recommended pharmacological therapy for IPF. The INPULSIS trials demonstrated that nintedanib reduces the rate of FVC decline. Immunosuppression with prednisolone, azathioprine, and NAC was shown to be harmful in the PANTHER-IPF trial. This patient should also be assessed for lung transplant eligibility given his low DLCO.

Reference: eTG – 2025 – Respiratory; TSANZ – 2017 – IPF Position Statement