Researchers reported that pulmonary rehabilitation could mitigate the negative effects of antifibrotic medications in patients with idiopathic pulmonary fibrosis (IPF), according to a study published in the Journal of Clinical Medicine.

“Although patients with idiopathic pulmonary fibrosis (IPF) often receive treatment with antifibrotic drugs (AFDs) and pulmonary rehabilitation (PR) concurrently, there are no reports on the effect of PR on patients with IPF receiving AFDs,” the authors of the study prefaced.

Because IPF is a rare, irreversible, and progressive disease, its prognosis is exceptionally poor. One way to counter pathological fibrosis of the lungs is to employ the use of AFDs; among the most commonly used AFDs are pirfenidone and nintedanib. 

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Although previous research indicates that AFDs play a role in suppressing the progression of IPF, evidence is scarce regarding their abilities to improve IPF-associated dyspnea, exercise intolerance, and reduced quality of life. Hence, PR has been proposed as a nonpharmacological intervention. 

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It is important to note that AFDs inevitably come with some adverse effects, some more serious than others. Thus, the authors of the study aimed to study the efficacy of PR as a nonpharmacological treatment of IPF. 

They collected data from 114 participants with IPF who were previously enrolled in the Toho Rehabilitation for Interstitial Pneumonia (TRIP) study between July 2014 and February 2019. Disease severity was evaluated for 3 months via an outpatient PR program. 

The participants underwent weekly 60-minute PR sessions on an outpatient basis. Physical activity, exercise capacity, degree of dyspnea, and vital signs were recorded. 

The results demonstrated that patients undergoing PR performed significantly better on the 6-minute walk test than the controls. This is in line with recent systematic reviews, which demonstrated that PR could reduce dyspnea and improve exercise tolerance and quality of life parameters. 

“This study examined the effects of PR with concurrent AFD treatment in patients with IPF,” the authors of the study wrote. “It was suggested that while AFDs reduced exercise tolerance and [health-related quality of life] at 3 months, the concurrent use of PR may prevent or mitigate these effects.”


Iwanami Y, Ebihara K, Nakao K, et al. Benefits of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis receiving antifibrotic drug treatmentJ Clin Med. 2022;11(18):5336. doi:10.3390/jcm11185336