Abstract | BACKGROUND: METHODS: We conducted a retrospective, observational study of 15 patients with LAM who underwent sirolimus therapy for more than 6 months. The efficacy was evaluated by reviewing the patients' clinical courses, pulmonary function and chest radiologic findings before and after the initiation of sirolimus treatment. RESULTS: All patients had blood trough levels of sirolimus lower than 5ng/mL. Sirolimus treatment improved the annual rates of change in FVC and FEV1 in the 9 patients who were free from chylous effusion (FVC, -101.0 vs. +190.0mL/y, p=0.046 and FEV1, -115.4 vs. +127.8mL/y, p=0.015). The remaining 7 patients had chylous effusion at the start of sirolimus treatment; the chylothorax resolved completely within 1-5 months of treatment in 6 of these cases. These results resembled those of previous studies in which blood trough levels of sirolimus ranged from 5 to 15ng/mL. CONCLUSIONS: Low-dose sirolimus (trough level, 5ng/mL or less) performed as well as the higher doses used previously for improving pulmonary function and decreasing chylous effusion in patients with LAM.
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Authors | Katsutoshi Ando, Masatoshi Kurihara, Hideyuki Kataoka, Masako Ueyama, Shinsaku Togo, Teruhiko Sato, Tokuhide Doi, Shin-ichiro Iwakami, Kazuhisa Takahashi, Kuniaki Seyama, Masashi Mikami |
Journal | Respiratory investigation
(Respir Investig)
Vol. 51
Issue 3
Pg. 175-83
(Sep 2013)
ISSN: 2212-5353 [Electronic] Netherlands |
PMID | 23978644
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2013 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved. |
Chemical References |
- Antibiotics, Antineoplastic
- MTOR protein, human
- TOR Serine-Threonine Kinases
- Sirolimus
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Topics |
- Adult
- Antibiotics, Antineoplastic
(administration & dosage)
- Chylothorax
(drug therapy, etiology)
- Female
- Forced Expiratory Volume
- Humans
- Lung Neoplasms
(complications, drug therapy, genetics, physiopathology)
- Lymphangiomyoma
(complications, drug therapy, genetics, physiopathology)
- Male
- Middle Aged
- Molecular Targeted Therapy
- Pleural Effusion, Malignant
(drug therapy, etiology)
- Retrospective Studies
- Sirolimus
(administration & dosage, blood)
- TOR Serine-Threonine Kinases
- Treatment Outcome
- Vital Capacity
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