The results of a clinical trial on IPF treatment drugs published in the New England Journal in May this year give a ray of hope for the treatment of IPF. Comprehensive IPF throughout the development of the disease, the future treatment of IPF is summarized as follows. Jiang Handong, Department of Respiratory Medicine, Shanghai Renji Hospital 1. Anti-pulmonary fibrosis treatment with pirfenidone: 1) The ASCEND study was mainly to clarify the effect of pirfenidone on the progression of idiopathic pulmonary fibrosis. The results found that at week 52 after treatment, the FVC in the pirfenidone group decreased by more than 10% or 47.9% fewer deaths compared to the control group, and the mean reduction in lung function at week 52 was 235 ml in the pirfenidone group compared to 428 ml in the second control group, and the reduction in FVC in pirfenidone compared to the control group was 193 ml. In terms of reducing IPF mortality, the study by pooling CAPACITY The 1-year risk of death with pirfenidone was found to be 48% lower than the control group. The combined studies and meta-analyses of pirfenidone in IPF suggest that it may be an effective drug for the treatment of IPF in the future: delaying the decline in lung function, improving exercise tolerance, and improving survival. 2. Nintedanib (nidanib): This is a targeted drug for the treatment of tumors, but phase II clinical findings suggest that it may delay the deterioration of pulmonary function in idiopathic pulmonary fibrosis, reduce the number of acute exacerbations, and improve quality of life. The recent phase III clinical results of its therapeutic effect on idiopathic pulmonary fibrosis: the results of INPULSIS-1 study found that the annual FVC reduction value of nintedanib was -114.7 ml, a significant reduction compared to the control group -239.9 ml, and the results of INPULSIS-2 also found an annual FVC reduction value of -113.6 ml for this drug, a significant reduction compared to the control group of -207.3 ml. In summary, the study of nidanib is also expected to be a drug for the treatment of IPF, and the application for marketing authorization for nidanib as a new drug for the treatment of IPF has been accepted in Europe.3. The results of the PANTHER-IPF study of N-acetylcysteine (NAC) alone for the treatment of IPF were relatively disappointing, with no significant difference between NAC and controls in terms of both FVC change and death. However, because the trial was initially designed to evaluate a comparative study of a three-drug combination (combination hormone + azathioprine + NAC) versus NAC and placebo, the trial was terminated and patients were informed midway through the trial when an increase in deaths was found in the three-drug combination treatment group. There is some controversy surrounding this trial due to the change from three groups in the original trial to two groups and the differences in the trial results that occurred before and after informing patients. However, the current findings do not support the application of NAC therapy alone for moderate to severe IPF. Anti-complication therapy and other therapies: IPF is often combined with multiple diseases including coronary heart disease, diabetes, hypertension, pulmonary embolism, gastroesophageal reflux, and sleep apnea syndrome. Retrospective studies have found that controlling gastroesophageal reflux technology reduces mortality and the incidence of acute exacerbations, but further studies are needed to clarify this. In recent years rehabilitation has also been found to improve the quality of life of patients with mild to moderate disease