Hyung et al. (2023) investigated whether pulse corticosteroid therapy (≥250 mg/day) improves survival in patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) compared to conventional non-pulse dosing. A retrospective analysis of 238 patients treated at Seoul National University Hospital from 2013 to 2021 was conducted. The study utilized AVIEW Lung Texture software to quantitatively analyze chest CT images, assessing lung abnormalities like consolidation and ground-glass opacity. Despite pulse therapy being common, results showed no significant improvement in 3-month or 12-month survival compared to non-pulse therapy. Both multivariable regression and propensity score-matched analyses supported these findings. Patients receiving non-pulse therapy showed higher levels of inflammatory markers and greater lung consolidation, but survival outcomes were not notably different. The study challenges the benefit of pulse corticosteroid therapy, emphasizing the need for prospective trials to establish optimal treatment protocols in AE-IPF.
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