[Nation-wide survey for the treatment with cyclosporin A of interstitial pneumonia associated with collagen diseases].

Abstract

OBJECTIVES:

This study was performed to investigate the efficacy and safety of cyclosporin A (CsA) for the treatment of interstitial pneumonia (IP) associated with collagen diseases in Japan.

METHODS:

Questionnaires were sent to 36 hospitals specializing in collagen diseases.

RESULTS:

Fifty-eight patients (7 polymyositis (PM), 19 dermatomyositis (DM), 7 systemic sclerosis (SSc), 7 rheumatoid arthritis (RA), 2 mixed connective tissue disease (MCTD), 1 systemic lupus erythematosus (SLE) and 1 Sjögren's syndrome (SS), 1 RA + SSc, 2 PM + SSc, 1 DM + SLE, and 10 idiopathic interstitial pneumonia (IIP) with IP were treated with CsA at 14 hospitals. IP was classified into the acute or chronic type. In the PM/DM group (7 PM, 19 DM, 2 PM + SSC, 1 DM + SLE), 65.5% were the acute type. In the other collagen disease group (7 SSc, 7 RA, 2 MCTD, 1 SLE, 1 SS, and 1 RA + SSc) and IIP group, 36.8% and 50% were the acute type, respectively. Mean dosages of CsA were 3.7 +/- 1.3 mg/kg/day for the PM/DM group, 3.0 +/- 1.0 for the other collagen disease group, and 3.8 +/- 4.8 for the IIP group. Oral corticosteroids were administered in combination with CsA in 100, 73.7, and 70% of the patients with PM/DM, other collagen disease, and IIP groups, respectively. CsA was effective for 72.2, 33.3, and 25% of the acute IP cases in the PM/DM, other collagen disease, and IIP groups, respectively. CsA was effective for 50.0, 50.0, and 60.0% of chronic IP cases in the PM/DM, other collagen disease, and IIP groups, respectively. Twenty-three adverse effects were observed, but most of them ameliorated upon withdrawal or reduction of the CsA dose.

CONCLUSION:

CsA is effective for the treatment of acute type IP associated with collagen diseases, especially PM/DM. To perform a prospective multi-center trial, standards for the recruitment of patients, efficacy assessments, and trial course and treatment should be determined carefully.

• Authors: M Harigai, M Hara, N Kamatani, S Kashiwazaki
• Journal: Ryumachi. [Rheumatism] (Ryumachi) Vol. 39 Issue 6 Pg. 819-28 (Dec 1999) ISSN: 0300-9157 [Print] Japan
• PMID: 10695405 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Immunosuppressive Agents
• Cyclosporine
• Prednisolone

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Collagen Diseases (complications)
• Cyclosporine (therapeutic use)
• Dermatomyositis (complications)
• Drug Therapy, Combination
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lung Diseases, Interstitial (complications, drug therapy)
• Male
• Polymyositis (complications)
• Prednisolone (therapeutic use)
• Prospective Studies
• Surveys and Questionnaires
• Treatment Outcome