Pamrevlumab in idiopathic pulmonary fibrosis

In The Lancet Respiratory Medicine, Luca Richeldi and colleagues1 report the safety and efficacy of pamrevlumab (FG-3019), a human monoclonal antibody against connective tissue growth factor, in a randomised, double-blind, placebo-controlled phase 2 trial done in patients with idiopathic pulmonary fibrosis. In view of the encouraging observations reported, it should be stressed at the outset that the results must be treated with caution pending an adequately powered phase 3 study. We have been here before: apparently striking treatment effects in idiopathic pulmonary fibrosis have been greeted with enthusiasm, but ultimately led to disappointment, as in an initial report of the efficacy of interferon gamma in idiopathic pulmonary fibrosis, admittedly in a tiny cohort.