TABLE 1.

Comparison of evidence-based treatment recommendations in the 2011 and 2015 guidelines for idiopathic pulmonary fibrosis

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¶
Antipulmonary hypertension therapy for idiopathic pulmonary fibrosis-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

Reproduced from [3], with permission from the publisher. ^#: moderate confidence in effect estimates; ^¶: low confidence in effect estimates; ⁺: very low confidence in effect estimates.