The goal, with the available therapies, is to begin treatment before end-stage fibrosis is present. Immunosuppressive drugs are used to control the inflammatory component of the disease, with corticosteroids being the standard choice. However, corticosteroid dosages are often high, and related side effects may require a decrease in dosage or termination of treatment, even if the patient has responded. The response to therapy in ILD varies quite widely. Depending upon the disease, therapy may be considered successful with an improvement or stabilization of symptoms and radiographic and physiologic abnormalities, as the natural history of most ILD is a gradual worsening of all of these parameters.
Supplemental oxygen helps to prevent complications from hypoxia.
With its use, patients experience an improved sense of well-being, tolerate activity and exercise, and report improved rest and sleep. A routine exercise program may be included as part of a comprehensive approach. Exercise contributes to aerobic cardiovascular fitness, bone mass while on corticosteroid therapy, weight control, and an overall sense of well-being. All patients with ILD should be considered for a pneumococcal vaccine and a yearly influenza vaccine. As the disease progresses, radiographic and physiologic abnormalities worsen and gas exchange deteriorates.