Date of Award

2014

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not sildenafil improves physical function in patients with idiopathic pulmonary fibrosis.

STUDY DESIGN: Review of 3 primary research studies published in the English language between 2007 and 2010.

DATA SOURCES: Two randomized, double blind, placebo controlled clinical trials, and one open label study analyzing the effect of sildenafil on patients with idiopathic pulmonary fibrosis were found using PubMed.

OUTCOME MEASURED: The primary tool used to assess physical function in patients with idiopathic pulmonary fibrosis, when treated with sildenafil, was a 6-minute walk distance. Distances were compared before and after treatment to assess for efficacy.

RESULTS: Two randomized controlled trials showed sildenafil was not effective at increasing physical function, and one open label study showed improved physical function. The study by the idiopathic pulmonary fibrosis clinical research network showed no significant difference between the sildenafil and control groups at 12 weeks. The study by Jackson et al. found sildenafil did not improve physical function in patients with idiopathic pulmonary fibrosis. The open label study by Collard et al. showed that when patients with idiopathic pulmonary fibrosis were given sildenafil, the majority showed improved physical function.

CONCLUSIONS: Based on the analysis of the two randomized controlled trials, sildenafil does not improve physical function. The open label study did show improved physical function in the majority of patients with idiopathic pulmonary fibrosis, but this is weak correlation at best, since it is neither randomized nor controlled.

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