ADVANCES IN THE TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS: THE CURRENT SCENARIO AND FUTURE PERSPECTIVES
Idiopathic Pulmonary Fibrosis (IPF) is a chronic and progressive interstitial lung disease characterized by fibrotic remodeling and irreversible decline in lung function. The present study aims to perform a critical and integrative analysis of the scientific evidence on therapeutic approaches for IPF, highlighting current antifibrotics, emerging therapies, and non-pharmacological support. This is a narrative review of the literature, structured from searches in databases such as PubMed/MEDLINE, SciELO, and Scopus, prioritizing clinical trials and recent guidelines. The pathophysiological understanding of the disease has evolved into an aberrant epithelial repair model, which boosted the use of specific antifibrotics, such as pirfenidone and nintedanib. These drugs demonstrate efficacy in halving the rate of decline in Forced Vital Capacity (FVC), although they do not reverse established fibrosis nor have a significant impact on long-term overall survival. Given the limitations in efficacy and tolerability, emerging multi-target therapies, such as nerandomilast (a phosphodiesterase 4B inhibitor) and inhaled treprostinil, show promising results in phase II and III trials for functional preservation. It is concluded that the management of IPF requires a multidisciplinary approach, integrating disease-modifying pharmacological therapies with pulmonary rehabilitation and symptomatic support, while new therapeutic options move towards consolidation and future clinical incorporation.