TNF and idiopathic pulmonary fibrosis: The PANTHER-IPF study, while limited by its multi-arm protocol and early termination, demonstrated that use of N-acetylcysteine (NAC) combined with the immunomodulatory agents prednisone and azathioprine was associated with an increased risk of death or hospitalization.91Additionally, inhibition of TNF-α with etanercept was shown to be an ineffective treatment modality for IPF.92Therefore, the use of anti-inflammatory maintenance therapy for IPF appears to be an ineffective strategy.