Abstract | OBJECTIVES: METHODS: Seventeen patients with PM/DM/amyopathic DM (mean age 51.4 +/- 10.4, mean follow-up 32 months) who received IVCYC for progressive interstitial pneumonia between August 1993 and October 2002 were studied. Nine patients had failed to respond to previous treatment with high-dose steroid and/or immunosuppressant. Cyclophosphamide (300-800 mg/m2) was given at least six times every 4 weeks. Oral prednisolone (0.5-1 mg/kg/day) was administered for the first 2 weeks and was gradually tapered. Response to treatment was evaluated based on the degree of exertional dyspnea, pulmonary function test and high-resolution computed tomography (HRCT). RESULTS: Eleven of 17 patients showed improvement in their dyspnea; six out of seven patients who had required oxygen treatment before IVCYC no longer did so after IVCYC. Eight of 17 patients had >or=10% improvement of vital capacity (VC)% and 9/17 had >or=10 point reduction in their HRCT score. Twelve patients had exhibited at least one result. Two patients with anti-Jo-1 antibodies showed a flare-up of interstitial pneumonia or myositis. After the IVCYC therapy, mean VC% improved by 15% (from 68 to 83%, P = 0.0034). The extent of abnormal lesions in HRCT was reduced from 24 to 13% (P = 0.0055). There was neither death nor severe toxicities observed. CONCLUSIONS: In this open-label study, IVCYC improved symptoms, pulmonary function tests and HRCT findings in patients with PM/DM. Longitudinal controlled studies are required to further confirm the efficacy of IVCYC.
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Authors | Y Yamasaki, H Yamada, M Yamasaki, M Ohkubo, K Azuma, S Matsuoka, Y Kurihara, H Osada, M Satoh, S Ozaki |
Journal | Rheumatology (Oxford, England)
(Rheumatology (Oxford))
Vol. 46
Issue 1
Pg. 124-30
(Jan 2007)
ISSN: 1462-0324 [Print] England |
PMID | 16754626
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Immunosuppressive Agents
- Cyclophosphamide
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Cyclophosphamide
(administration & dosage, adverse effects, therapeutic use)
- Dermatomyositis
(complications)
- Disease Progression
- Drug Administration Schedule
- Dyspnea
(drug therapy, etiology)
- Humans
- Immunosuppressive Agents
(administration & dosage, adverse effects, therapeutic use)
- Injections, Intravenous
- Lung Diseases, Interstitial
(diagnostic imaging, drug therapy, etiology, physiopathology)
- Middle Aged
- Polymyositis
(complications)
- Tomography, X-Ray Computed
- Treatment Outcome
- Vital Capacity
(drug effects)
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