To date, only a few randomized studies have been performed in patients with IPF and PH to evaluate the efficacy of drugs, such as ambrisentan, sildenafil, and bosentan, commonly used for the treatment of iPAH. The ambrisentan PH-IPF trial, one of the most recent studies, was interrupted prematurely because of a lack of superior activity of the experimental arm (unpublished data from the terminated trial NCT00879229). While we are waiting for the eventual publication of the results obtained from the 40 patients (25 of them treated with the drug and 15 with placebo) evaluated in the trial after randomization, we can highlight some of the limitations of this study design, which have also been observed in other studies. First, patients who were deemed eligible for enrollment included not only those with a pulmonary arterial pressure (PAP) >35 mm Hg, but also subjects with a mean PAP >25 mm Hg. Second, the 6-min walk test, which is a nonvalidated and probably misleading test, was chosen as the primary end point. This test has not yet been validated as a useful screen for PH in IPF, and its prognostic significance is still unknown. Biased selection of study populations, primary end points, or both raises the need for further well-designed studies to answer the question as to whether drugs can help these patients.