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This trial showed that co-trimoxazole did not reduce death or hospitalisations in people with moderate to very severe idiopathic pulmonary fibrosis.

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Andrew M Wilson 1,*, Allan B Clark 1, Anthony Cahn 2, Edwin R Chilvers 3, William Fraser 1, Matthew Hammond 4, David M Livermore 1, Toby M Maher 5, Helen Parfrey 6, Ann Marie Swart 4, Susan Stirling 4, David Thickett 7, Moira Whyte 8

1 Norwich Medical School, University of East Anglia, Norwich, UK
2 Department of Respiratory Medicine, Bedford Hospitals NHS Trust, Bedford, UK
3 ICTEM building, Hammersmith Campus, Imperial College London, London, UK
4 Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
5 Department of Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, Royal Brompton Hospital, London, UK
6 Department of Respiratory Medicine, Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
7 Birmingham Acute Care Research Group, University of Birmingham, Birmingham, UK
8 Medical Research Council Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
* Corresponding author Email: a.m.wilson@uea.ac.uk

Declared competing interests of authors: David Livermore reports personal fees from Accelerate (Tucson, AZ, USA), Allecra Therapeutics GmbH (Basel, Switzerland), Antabio (Labège, France), Centauri (Sandwich, UK), Entasis (Waltham, MA, USA), Integra-Holdings (Jerusalem, Israel), Meiji Holdings Co., Ltd (Yokohama, Japan), Melinta Therapeutics (Morristown, NJ, USA), Menarini Group (Florence, Italy), Mutabilis (Romainville, France), Nordic (Reading, UK), ParaPharm Development Ltd (Reading, UK), Pfizer Inc. (New York, NY, USA), Qpex Biopharma (San Diego, CA, USA), Roche Holding AG (Basel, Switzerland; Welwyn Garden City, UK), Shionogi B.V. (Amsterdam, the Netherlands), T.A.Z. (Grand Cayman, Cayman Islands), Tetraphase Pharmaceuticals, Inc. (Watertown, MA, USA), Venatorx Pharmaceuticals (Malvern, PA, USA), Wockhardt (Aurangabad, India), Zambon Pharma (Milan, Italy), Astellas Pharma (Tokyo, Japan), bioMérieux SA (Marcy l’Etoile, France), Beckman Coulter Inc. (West Sacramento, CA, USA), Cardiome (Vancouver, BC, Canada), Cepheid (Sunnyvale, CA, USA) and Merck/MSD (Rahway, NJ, USA); other fees from Dechra Pharmaceuticals (Northwich, UK), GlaxoSmithKline plc (Brentford, UK), Merck (Rahway, NJ, USA), PerkinElmer® Inc. (Waltham, MA, USA), Pfizer Inc., Roche Holding AG (Welwyn Garden City, UK), Boehringer Ingelheim (Brackness, UK), Zambon, GlaxoSmithKline Research and Development (R&D) (Brentford, UK) and Pfizer Inc. (Sandwich, UK), outside the submitted work; and was a member of the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Antimicrobial Resistance Themed Call Board (2013–14). Toby Maher reports grants and personal fees from GlaxoSmithKline R&D and AstraZeneca plc (Cambridge, UK); grants, personal fees and non-financial support from UCB Pharma (Slough, UK); personal fees from Boehringer Ingelheim, Roche Holding AG, Bayer HealthCare (Leverkeusen, Germany), Prometic (Toronto, ON, Canada), Samumed (San Diego, CA, USA), Galapagos (Mechelen, Belgium), Celgene (Summit, NJ, USA), Indalo (St Louis, KY, USA), Pliant (San Francisco, CA, USA), Blade Therapeutics, Inc. (San Francisco, CA, USA), Respivant (San Diego, CA, USA), Novartis Pharmaceuticals (Basel, Switzerland) and Bristol-Myers Squibb (New York, NY, USA); and stock options from Apellis Pharmaceuticals (Waltham, MA, USA), outside the submitted work. Helen Parfrey reports educational grants, conference attendance and personal fees from Roche Holding AG and Boehringer Ingelheim. She is a trustee of the charity Action for Pulmonary Fibrosis (Peterborough, UK). Anne Marie Swart was part of the NIHR HTA Efficient Study Designs Board 2014–16 and is currently part of the Clinical Trials Unit Standing Advisory Committee. Moira Whyte was part of the NIHR Efficacy and Mechanism Evaluation Funding Committee 2008–14. Andrew Wilson reports investigator-initiated research grant funding from Roche Holding AG.

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