Use of intermittent, intravenous cyclophosphamide for idiopathic pulmonary fibrosis.

Abstract

STUDY OBJECTIVE:

To determine the safety and efficacy of intravenous cyclophosphamide for patients with idiopathic pulmonary fibrosis.

DESIGN:

Nonrandomized, open-labeled study of efficacy in symptomatic patients.

SETTING:

Patients were treated as outpatients in a referral clinic.

PATIENTS:

All patients had idiopathic pulmonary fibrosis with symptoms of dyspnea on exertion. Patients had either worsening disease or contraindication to corticosteroids.

INTERVENTION:

Thirty-three patients were treated with intravenous cyclophosphamide every two weeks. Initial dosage was 500 mg, and the dose was escalated provided the total white blood cell count remained > 3,000 cells per cubic millimeter. The maximum dose administered was 1,000 to 1,800 mg of cyclophosphamide. Corticosteroid therapy was tapered as tolerated by the patient.

MEASUREMENTS AND RESULTS:

Patients were treated for at least six months or until death. For the 33 patients, 18-month probability of survival was > 50 percent. For those patients surviving six months, there was a significant rise in the vital capacity (from 1.6 +/- .61 L [mean +/- SD] to 1.8 +/- .52 L, p < 0.01) which persisted for at least 18 months of treatment. This was associated with a significant fall in the average prednisone dosage from 32 +/- 13.0 mg/day to 4 +/- 10.4 mg/day (p < 0.01) by 12 months. Only one patient required hospitalization for possible drug-related toxic reaction.

CONCLUSIONS:

Intermittent, intravenous cyclophosphamide therapy was associated with improved pulmonary function and reduced corticosteroid dosage in patients with idiopathic pulmonary fibrosis who survived at least six months after institution of therapy.

• Authors: R P Baughman, E E Lower
• Journal: Chest (Chest) Vol. 102 Issue 4 Pg. 1090-4 (Oct 1992) ISSN: 0012-3692 [Print] United States
• PMID: 1395749 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Cyclophosphamide
• Prednisone

Topics

• Cyclophosphamide (administration & dosage, adverse effects)
• Drug Administration Schedule
• Female
• Humans
• Infusions, Intravenous
• Male
• Middle Aged
• Prednisone (therapeutic use)
• Pulmonary Fibrosis (drug therapy, physiopathology)
• Vital Capacity