Cyclosporin treatment in steroid-resistant and acutely exacerbated interstitial pneumonia.

Abstract

OBJECTIVE:

The aim of this study was to evaluate the efficacy of cyclosporin A (CsA) in patients with interstitial pneumonia (IP).

DESIGN:

Retrospective comparative study.

PATIENTS:

We reviewed 33 patients (23 males and 10 females with a mean age of 62.5 years) with histologically-proven progressive IP who were treated with CsA. All patients had corticosteroid-resistant IP or developed acute exacerbation of IP in their courses.

RESULTS:

The underlying systemic diseases were: idiopathic interstitial pneumonias (IIPs) in 19 patients, and collagen vascular diseases (CVDs) in 14. The histopathological patterns and underlying diseases of IP were classified as usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) in 10 patients, cellular-nonspecific interstitial pneumonia (NSIP)/IIPs in 3, fibrotic-NSIP/IIPs in 5, organizing pneumonia (OP)/IIP in 1, UIP/CVDs in 4, cellular-NSIP/CVDs in 7, fibrotic-NSIP/CVDs in 2, and diffuse alveolar damage (DAD)/CVD in 1, respectively. They received a low dosage of CsA combined with corticosteroids. The prognoses after treatment with CsA were well correlated with histopathological patterns. Cellular-NSIP and OP showed better prognoses than fibrotic-NSIP, UIP or DAD. In addition, CVDs had better prognoses than IIPs, when compared on the basis of the same histopathological patterns. Furthermore, the prognoses in the CsA-treated group were significantly better than in those without CsA treatment in regard to acute exacerbation of UIP/IPF.

CONCLUSIONS:

CsA combined with corticosteroids may be an efficacious treatment for corticosteroid-resistant IP and for acute exacerbation of IPF.

• Authors: Sakae Homma, Susumu Sakamoto, Masateru Kawabata, Kazuma Kishi, Eiyasu Tsuboi, Noriko Motoi, Kunihiko Yoshimura
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 44 Issue 11 Pg. 1144-50 (Nov 2005) ISSN: 0918-2918 [Print] Japan
• PMID: 16357451 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glucocorticoids
• Immunosuppressive Agents
• Cyclosporine

Topics

• Acute Disease
• Aged
• Cyclosporine (therapeutic use)
• Drug Resistance
• Female
• Follow-Up Studies
• Glucocorticoids (adverse effects)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lung Diseases, Interstitial (diagnosis, drug therapy, mortality)
• Male
• Middle Aged
• Respiratory Function Tests
• Retrospective Studies
• Survival Rate
• Tomography, X-Ray Computed
• Treatment Outcome