Abstract | STUDY OBJECTIVE: DESIGN: Retrospective study. SETTING: National Institutes of Health, Bethesda, MD. DESIGN AND SUBJECTS: The study population comprised 348 patients with LAM participating in a longitudinal research protocol. Declines in diffusion capacity of the lung for carbon monoxide (Dlco) and FEV(1) were measured in 275 patients observed for approximately 4 years. The declines in Dlco and FEV(1) of patients treated with progesterone, po (n = 67) or IM (n = 72), were compared with those of untreated patients (n = 136). MEASUREMENTS AND RESULTS: Overall yearly rates of decline in Dlco and FEV(1) were 2.4 +/- 0.4% predicted (0.69 +/- 0.07 mL/min/mm Hg) and 1.7 +/- 0.4% predicted (75 +/- 9 mL), respectively (mean +/- SEM). The most significant predictors of functional decline were initial lung function and age. After adjusting for initial FEV(1), age, and duration of disease, patients treated with IM progesterone tended to have lower rates of decline in FEV(1) than patients treated po (1.9 +/- 0.6% predicted vs 3.2 +/- 0.8% predicted, respectively; p = 0.081). However, there was no significant difference in rates of decline in FEV(1) between patients treated with IM progesterone and untreated patients (1.9 +/- 0.6% predicted vs 0.8 +/- 0.5% predicted, respectively; p = 0.520), and patients treated with po progesterone and untreated patients (3.2 +/- 0.8% predicted vs 0.8 +/- 0.5% predicted, respectively; p = 0.064). After adjusting for initial Dlco, rates of decline in Dlco were significantly higher in patients treated with po progesterone (3.6 +/- 0.7% predicted, p = 0.002) and IM progesterone (2.8 +/- 0.5% predicted, p = 0.022) than in untreated patients (1.6 +/- 0.6% predicted). CONCLUSIONS: Within the limitations of a retrospective study, our data suggest that progesterone therapy does not slow the decline in lung function in LAM.
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Authors | Angelo M Taveira-DaSilva, Mario P Stylianou, Carolyn J Hedin, Olanda Hathaway, Joel Moss |
Journal | Chest
(Chest)
Vol. 126
Issue 6
Pg. 1867-74
(Dec 2004)
ISSN: 0012-3692 [Print] United States |
PMID | 15596686
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
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Topics |
- Adult
- Aged
- Female
- Follow-Up Studies
- Forced Expiratory Volume
- Humans
- Lung
(physiopathology)
- Lymphangioleiomyomatosis
(drug therapy, physiopathology)
- Middle Aged
- Progesterone
(therapeutic use)
- Pulmonary Diffusing Capacity
- Respiratory Function Tests
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