Immunosuppressive therapies for pulmonary fibrosis

Your treatment will depend on the type of pulmonary fibrosis or interstitial lung disease that you have. Because everyone is different, you will be able to discuss your medication with your medical team so together you can find the treatment that suits you best.

Immunosuppressive therapies

Immunosuppressive therapies are used for certain conditions where inflammation in the lungs may also occur, such as hypersensitivity pneumonitis or autoimmune diseases including rheumatoid arthritis and systemic sclerosis. If you have IPF, find out about anti-fibrotic treatments.

Steroids

Steroids are anti-inflammatory medicines. When you are first diagnosed, you may be put on a high dose of steroids. The aim of the treatment is to reduce inflammation in your lungs in order to quickly bring the disease under control.

  • Prednisolone is the most commonly used steroid.
  • Take your medicines as prescribed by your medical team. It can be dangerous to come off steroids without discussing it with them first.
  • Your medical team will monitor you regularly and help you manage any side effects.
  • It’s normally best to take steroids with or straight after food.

Need to know about steroids

  • The most common side effects are increased appetite and weight gain, mood changes, indigestion and difficulty sleeping. But there are many other potential side effects.
  • If you are on steroids for a long time, you may develop osteoporosis (thinning of the bones), high blood sugar (diabetes), high blood pressure or cataracts. You will also have an increased risk of developing particular infections such as shingles or measles.
  • If you notice any changes in your body (not just your breathing), discuss them with your medical team as soon as you can.
Every few months, my medical team reviews my medication to check that it’s still beneficial for me to be on steroids.

Immunosuppressants

  • Immunosuppressants are used to dampen down overactive parts of your immune system.  
  • If your pulmonary fibrosis is caused by an autoimmune disease (such as rheumatoid arthritis, autoimmune myositis, Sjogren’s syndrome or systemic sclerosis) or hypersensitivity pneumonitis, you may take an immunosuppressant to reduce inflammation in your lungs.
  • Immunosuppressants used to treat these conditions include mycophenolate mofetil, cyclophosphamide, methotrexate, rituximab and azathioprine.
  • The side effects for immunosuppressants vary depending on which drug you’re taking. Your medical team or pharmacist should talk to you about the side effects when prescribing you with immunosuppressants. Discuss any new changes in your body with your medical team as soon as you notice them.

Other medications

You may also be offered other treatment – such as medications to help manage a cough or acid reflux and advice to manage breathlessness.

Information provided by Action for Pulmonary Fibrosis (APF) is not a substitute for professional medical advice. It’s intended as general information only. APF is not responsible for any errors or omissions or for any loss or damage suffered by users resulting from the information published on actionpf.org.

Further information for carers:

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