Prevalence and treatment of key comorbidities in interstitial lung diseases (ILDs)
| Comorbidity | Prevalence | Treatment |
| Infections | NA | Broad-spectrum antibiotics Adjust immunosuppression Prophylactic antibiotics in case of recurrent infections Specific therapy for chronic infections |
| Gastro-oesophageal reflux | 0–94% in IPF | Lifestyle changes PPIs, H2-receptor antagonists, prokinetics Fundoplication |
| Pulmonary hypertension | 32–85% in IPF, 5–74% in sarcoidosis and 5–12% in SSc | Treatment of contributing factors Anti-pulmonary hypertension treatment is not recommended in IPF but combination of antifibrotic agents with targeted therapy for pulmonary hypertension may be considered Combination of immunosuppression and anti-pulmonary hypertension agents in SSc-ILD |
| Cardiac disease | 60% in IPF, 20% in sarcoidosis | Immunosuppression when necessary Specific pharmacological treatment for cardiac disease ICD implantation (mainly in sarcoidosis) Consider the likelihood of drug-induced ILD |
| Pulmonary embolism | NA | Anticoagulation (avoid vit-K antagonists in IPF) |
| Lung cancer | 4.4–10% in IPF | Radiotherapy, chemotherapy, surgical removal Careful pre-operative assessment |
| Obstructive sleep apnoea | 60–90% in IPF, 50% in SSc-ILD, 65% in sarcoidosis | CPAP machine Follow-up to check compliance/adherence |
| Depression | >20% in ILDs, 11–50% in IPF | The role of antidepressants is under debate Pulmonary rehabilitation |
NA: not applicable; IPF: idiopathic pulmonary fibrosis; PPI; proton-pump inhibitor; SSc: systemic sclerosis; ICD: implantable cardioverter–defibrillator; vit-K: vitamin K; CPAP: continuous positive airway pressure.