Anti-reflux surgery promising in idiopathic pulmonary fibrosis

(HealthDay)—Laparoscopic antireflux surgery is safe and well-tolerated in patients with idiopathic pulmonary fibrosis (IPF) and abnormal acid gastroesophageal reflux (GER), according to a phase 2 study published in the Sept. 1 issue of The Lancet Respiratory Medicine.

Ganesh Raghu, M.D., from the University of Washington in Seattle, and colleagues performed a randomized controlled trial to assess whether treatment of abnormal acid GER with laparoscopic antireflux surgery reduced the rate of disease progression among 29 patients with IPF and abnormal acid GER recruited from six U.S. academic centers versus those not receiving surgery (29 patients).

After adjusting for baseline anti-fibrotic use in an intention-to-treat analysis, the researchers found that the rate of change in forced vital capacity over 48 weeks was −0.05 L (95 percent confidence interval, −0.15 to 0.05) in the surgery group and −0.13 L (95 percent confidence interval, −0.23 to −0.02) in the non-surgery group (P = 0.28). In the surgery group, acute exacerbation, respiratory-related hospitalization, and death were less common without statistical significance. The most common adverse events after surgery included dysphagia (29 percent) and abdominal distention (14 percent). In addition, there was one death in the surgery group and four deaths in the non-surgery group.

"A larger, well-powered, randomized controlled study of antireflux surgery is needed in this population," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.