Idiopathic pulmonary fibrosis: present understanding and future options.

T he past decade has been extraordinarily fruitful for the study and management of idiopathic pulmonary fibrosis (IPF). The ability of physicians to make a clear and definitive diagnosis has greatly improved, and a proliferation of clinical studies has started to build an evidence base upon which rational treatment decisions can be built. Nevertheless, the challenges facing patients and physicians remain formidable. The number of people dying from pulmonary fibrosis in the USA has increased by 50% in just 10 yrs (1992–2003) (fig. 1). The 175,088 deaths in such a short period highlight the devastating nature of this attritional lung disease, putting it on a par with many cancers in terms of outcome [1, 2].