***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Interstitial lung disease ( ILD ) is characterised by exertional dyspnoea , exercise limitation and reduced quality of life . The role of exercise training in this diverse patient group is unclear . The aims of this study were to establish the safety of exercise training in ILD ; its effects on exercise capacity , dyspnoea and quality of life ; and whether patients with idiopathic pulmonary fibrosis ( IPF ) had similar responses to those with other types of ILD . Methods : 57 subjects with ILD ( 34 IPF ) were r and omised to receive 8 weeks of supervised exercise training or weekly telephone support . The 6 min walk distance ( 6MWD ) , incremental exercise test , modified Medical Research Council ( MRC ) dyspnoea score and Chronic Respiratory Disease Question naire ( CRDQ ) were performed at baseline , following intervention and at 6 months . Results : 80 % of subjects completed the exercise programme and no adverse events were recorded . The 6MWD increased following training ( mean difference to control 35 m , 95 % CI 6 to 64 m ) . A significant reduction in MRC score was observed ( 0.7 points , 95 % CI 0.1 to 1.3 ) along with improvements in dyspnoea ( p = 0.04 ) and fatigue ( p<0.01 ) on the CRDQ . There was no change in peak oxygen uptake ;  however , exercise training  reduced heart rate at maximum isoworkload ( p = 0.01 ) . There were no significant differences in response between those with and without IPF . After 6 months there were no differences between the training and control group for any outcome variable . Conclusions : Exercise training improves exercise capacity and symptoms in patients with ILD , but these benefits are not sustained 6 months following intervention . Trial registration number : BACKGROUND Idiopathic pulmonary fibrosis is a fatal disease for which no effective treatment exists . We assessed whether treatment with interferon gamma-1b improved survival compared with placebo in patients with idiopathic pulmonary fibrosis and mild-to-moderate impairment of pulmonary function . METHODS 826 patients with idiopathic pulmonary fibrosis were enrolled from 81 centres in seven European countries , the USA , and Canada . Patients were r and omly assigned ( double-blind ) in a 2:1 ratio to receive 200 microg interferon gamma-1b ( n=551 ) or equivalent placebo ( n=275 ) subcutaneously , three times per week . Eligible patients were aged 40 - 79 years , had been diagnosed in the past 48 months , had a forced vital capacity of 55 - 90 % of the predicted value , and a haemoglobin-corrected carbon monoxide diffusing capacity of 35 - 90 % of the predicted value . The primary endpoint was overall survival time from r and omisation measured at the second interim analysis , when the proportion of deaths had reached 75 % of those expected by the study conclusion . This study is registered with Clinical Trials.gov , number NCT00075998 . FINDINGS At the second interim analysis , the hazard ratio for mortality in patients on interferon gamma-1b showed absence of minimum benefit compared with placebo ( 1.15 , 95 % CI 0.77 - 1.71 , p=0.497 ) , and indicated that the study should be stopped . After a median duration of 64 weeks ( IQR 41 - 84 ) on treatment , 80 ( 15 % ) patients on interferon gamma-1b and 35 ( 13 % ) on placebo had died . Almost all patients reported at least one adverse event , and more patients on interferon gamma-1b group had constitutional signs and symptoms ( influenza-like illness , fatigue , fever , and chills ) than did those on placebo . Occurrence of serious adverse events ( eg , pneumonia , respiratory failure ) was similar for both treatment groups . Treatment adherence was good and few patients discontinued treatment prematurely in either group . INTERPRETATION We can not recommend treatment with interferon gamma-1b since the drug did not improve survival for patients with idiopathic pulmonary fibrosis , which refutes previous findings from subgroup analyses of survival in studies of patients with mild-to-moderate physiological impairment of pulmonary function . FUNDING InterMune BACKGROUND AND OBJECTIVE Although pulmonary rehabilitation is effective for patients with COPD , its efficacy in patients with IPF is unknown . The purpose of this study was to evaluate the effects of pulmonary rehabilitation in IPF . METHODS Thirty patients diagnosed with IPF , according to the consensus statement , were r and omly assigned to the rehabilitation group or the control group . The pulmonary rehabilitation mainly consisted of a 10-week programme of exercise training .  Pulmonary function , blood gas analysis , 6MWD , dyspnoea rating with the baseline dyspnoea index and health-related quality of life score on the St George 's Respiratory Question naire were evaluated at baseline and after the programme . RESULTS Assessment of efficacy was carried out on 13 patients who completed the programme and 15 patients in the control group . There were no significant effects of the programme on measures of pulmonary function , values of arterial blood gas analysis or dyspnoea rating . Although there were some differences in the baseline 6MWD and total health-related quality of life score which were not statistically significant , marked improvements were observed in the 6MWD ( mean difference 46.3 m ( 95 % CI : 8.3 - 84.4 ) , P < 0.05 ) and the total health-related quality of life score ( -6.1 ( 95 % CI : -11.7 to -0.5 ) , P < 0.05 ) . CONCLUSIONS Pulmonary rehabilitation improves both exercise capacity and health-related quality of life in patients with IPF INTRODUCTION Idiopathic pulmonary fibrosis ( IPF ) is a severe chronic lung disease . Pulmonary rehabilitation could improve the quality of life of patients with this condition . METHODS We prospect ively evaluated the impact of an 8-week home-based pulmonary rehabilitation programme over 10 months in stable patients suffering from IPF . Exercise capacity , pulmonary function , dyspnoea and quality of life were analyzed before and after the rehabilitation programme . RESULTS Seventeen patients were included and 13 completed the study . Mean functional vital capacity ( FVC ) was 2.15±0.79L and mean diffusing capacity for carbon monoxide ( DLCO ) was 7.81±3.99mL/min/mmHg . Six patients were treated with low dose oral steroids ( 20mg/day of prednisone ) with or without immunosuppressive treatments ; six were taking part in therapeutic trials . Mean endurance time ( 7.4±9.1 min vs. 14.1±12.1 min ; P=0.01 ) , number of steps per minute on a stepper ( 322±97 vs. 456±163 ; P=0.026 ) , six-minute walk distance relative to heart rate ( HR ) ( 11±6 vs. 17±12 ; P=0.006 ) , exercise dyspnoea ( P=0.026 ) , sensation of physical limitation on the SF-36 ( 25%±26 vs. 49%±38 ; P=0.047 ) and four out of seven visual analogue scales were significantly improved after rehabilitation . In contrast , no significant difference was observed in resting pulmonary function or in other items on quality of life question naires . CONCLUSION A home-based programme of pulmonary rehabilitation is feasible in IPF patients . It significantly improved endurance parameters and physical limitation in this patient group without changing pulmonary function BACKGROUND Idiopathic pulmonary fibrosis is a progressive and fatal lung disease with inevitable loss of lung function . The CAPACITY programme ( studies 004 and 006 ) was design ed to confirm the results of a phase 2 study that suggested that pirfenidone , a novel antifibrotic and anti-inflammatory drug , reduces deterioration in lung function in patients with idiopathic pulmonary fibrosis . METHODS In two concurrent trials ( 004 and 006 ) , patients ( aged 40 - 80 years ) with idiopathic pulmonary fibrosis were r and omly assigned to oral pirfenidone or placebo for a minimum of 72 weeks in 110 centres in Australia , Europe , and North America . In study 004 , patients were assigned in a 2:1:2 ratio to pirfenidone 2403 mg/day , pirfenidone 1197 mg/day , or placebo ; in study 006 , patients were assigned in a 1:1 ratio to pirfenidone 2403 mg/day or placebo . The r and omisation code ( permuted block design ) was computer generated and stratified by region . All study personnel were masked to treatment group assignment until after final data base lock . Treatments were administered orally , 801 mg or 399 mg three times a day . The primary endpoint was change in percentage predicted forced vital capacity ( FVC ) at week 72 . Analysis was by intention to treat . The studies are registered with Clinical Trials.gov , numbers NCT00287729 and NCT00287716 . FINDINGS In study 004 , 174 of 435 patients were assigned to pirfenidone 2403 mg/day , 87 to pirfenidone 1197 mg/day , and 174 to placebo . In study 006 , 171 of 344 patients were assigned to pirfenidone 2403 mg/day , and 173 to placebo . All patients in both studies were analysed . In study 004 , pirfenidone reduced decline in FVC ( p=0·001 ) . Mean FVC change at week 72 was -8·0 % ( SD 16·5 ) in the pirfenidone 2403 mg/day group and -12·4 % ( 18·5 ) in the placebo group ( difference 4·4 % , 95 % CI 0·7 to 9·1 ) ; 35 ( 20 % ) of 174 versus 60 ( 35 % ) of 174 patients , respectively , had a decline of at least 10 % . A significant treatment effect was noted at all timepoints from week 24 and in an analysis over all study timepoints ( p=0·0007 ) . Mean change in percentage FVC in the pirfenidone 1197 mg/day group was intermediate to that in the pirfenidone 2403 mg/day and placebo groups . In study 006 , the difference between groups in FVC change at week 72 was not significant ( p=0·501 ) . Mean change in FVC at week 72 was -9·0 % ( SD 19·6 ) in the pirfenidone group and -9·6 % ( 19·1 ) in the placebo group , and the difference between groups in predicted FVC change at week 72 was not significant ( 0·6 % , -3·5 to 4·7 ) ; however , a consistent pirfenidone effect was apparent until week 48 ( p=0·005 ) and in an analysis of all study timepoints ( p=0·007 ) . Patients in the pirfenidone 2403 mg/day group had higher incidences of nausea ( 125 [ 36 % ] of 345 vs 60 [ 17 % ] of 347 ) , dyspepsia ( 66 [ 19 % ] vs 26 [ 7 % ] ) , vomiting ( 47 [ 14 % ] vs 15 [ 4 % ] ) , anorexia ( 37 [ 11 % ] vs 13 [ 4 % ] ) , photosensitivity ( 42 [ 12 % ] vs 6 [ 2 % ] ) , rash ( 111 [ 32 % ] vs 40 [ 12 % ] ) , and dizziness ( 63 [ 18 % ] vs 35 [ 10 % ] ) than did those in the placebo group . Fewer overall deaths ( 19 [ 6 % ] vs 29 [ 8 % ] ) and fewer deaths related to idiopathic pulmonary fibrosis ( 12 [ 3 % ] vs 25 [ 7 % ] ) occurred in the pirfenidone 2403 mg/day groups than in the placebo groups . INTERPRETATION The data show pirfenidone has a favourable benefit risk profile and represents an appropriate treatment option for patients with idiopathic pulmonary fibrosis . FUNDING InterMune Objective The aim of this study was to investigate the effects of a home-based pulmonary rehabilitation program on the functional outcome parameters in patients with idiopathic pulmonary fibrosis ( IPF ) . Design A prospect i ve study . Patients Seventeen patients diagnosed with IPF . Methods A home-based pulmonary rehabilitation program was carried out in 17 IPF patients for 12 weeks . Dyspnea severity during daily life activities ( Medical Research Council Scale ) , pulmonary function ( pulmonary function test ) , exercise capacity ( 6-minute walking test , 6MWD ) , and general health related quality of life ( Medical Outcomes Short Form-36 ) were evaluated . Results A significant decrease in perceived dyspnea ( p = 0.003 ) and leg fatigue ( p < 0.05 ) severities , and an increase in the 6MWD ( p = 0.04 ) and general health related quality of life scores ( health perception , physical role , and emotional status subsc 
    Output:
    
Meta-analyses showed no significant effect of interferon γ-1b or sildenafil on 6-minute walking distance ( 6MWD ) or dyspnoea .
Both pulmonary rehabilitation and sildenafil showed a trend towards significance in improving QoL. There was weak evidence for the improvement of 6MWD using oxygen ; dyspnoea using prednisolone , diamorphine , D-pencillamine and colchicine ; cough using  interferon α and thalidomide ; anxiety using  diamorphine ; fatigue using pulmonary rehabilitation ; and QoL using thalidomide and doxycycline .