|
 |
|
|||||||
|
|||||||||
Copyright © ERS Journals Ltd 1998
Original Articles |
Cyclophosphamide pulse therapy in idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is a progressive disorder with poor prognosis. Response to treatment is infrequent and the use of immunosuppressive agents other than corticosteroids is the subject of ongoing discussion because of uncertain efficacy and side-effects. To determine the efficacy and safety of cyclophosphamide pulse therapy in IPF, this study retrospectively analysed 18 patients with progressive IPF who were treated with intermittent i.v. cyclophosphamide (1-13 g x month(-1)) and additional oral prednisolone for 1 yr. Static lung volumes, arterial oxygen tension (Pa,O2) at rest, clinical symptoms and potential treatment-related side-effects were recorded. Cyclophosphamide had to be stopped in one patient, owing to repeated pulmonary infection; 11 patients were responders (five improving, six stabilizing) and six patients deteriorated. The change in vital capacity (VC) of responders was +6.7+/-18.0% (mean +/-SD), compared with -20.6+/-18.2% in nonresponders (p=0.008). Pa,O2 remained constant in responders (+0.13+/-0.88 kPa (+1.0+/-6.6 mmHg)), while it decreased in nonresponders (-2.08+/-1.92 kPa (-15.6+/-14.4 mmHg, p=0.008)). Additional prednisolone was reduced by 19.1+/-13.4 mg in responders, compared with 6.7+/-16.3 mg in nonresponders (p=0.02). VC at initiation of therapy was higher in responders (60.2+/-10.2 versus 40.3+/-12.9% predicted; p=0.004). No side-effects occurred, other than respiratory tract infection. These data demonstrate that intravenous cyclophosphamide pulse therapy may be a favourable regimen for certain patients with progressive idiopathic pulmonary fibrosis. Patients with a vital capacity of more than 50% predicted and a shorter duration of disease may benefit most.
This article has been cited by other articles:
|
|
 |
|
  J. P. Lynch III Idiopathic Pulmonary Fibrosis, Nonspecific Interstitial Pneumonia/Fibrosis, and Sarcoidosis ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 635 - 686. [Full Text] [PDF]
|
|
|
|
 |
|
 A U Wells, N Hirani, and on behalf of the BTS Interstitial Lung Disease Gui Interstitial lung disease guideline Thorax, September 1, 2008; 63(Suppl_5): v1 - v58. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Rogliani, M. Mura, M. Assunta Porretta, and C. Saltini Review: New perspectives in the treatment of idiopathic pulmonary fibrosis Therapeutic Advances in Respiratory Disease, April 1, 2008; 2(2): 75 - 93. [Abstract] [PDF]
|
|
|
|
 |
|
 Y. Yamasaki, H. Yamada, M. Yamasaki, M. Ohkubo, K. Azuma, S. Matsuoka, Y. Kurihara, H. Osada, M. Satoh, and S. Ozaki Intravenous cyclophosphamide therapy for progressive interstitial pneumonia in patients with polymyositis/dermatomyositis Rheumatology, January 1, 2007; 46(1): 124 - 130. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Walter, H. R. Collard, and T. E. King Jr. Current perspectives on the treatment of idiopathic pulmonary fibrosis. Proceedings of the ATS, January 1, 2006; 3(4): 330 - 338. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Bouros and K. M. Antoniou Current and future therapeutic approaches in idiopathic pulmonary fibrosis Eur. Respir. J., October 1, 2005; 26(4): 693 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. R. Collard and T. E. King Jr Demystifying Idiopathic Interstitial Pneumonia Arch Intern Med, January 13, 2003; 163(1): 17 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Gross and G. W. Hunninghake Idiopathic Pulmonary Fibrosis N. Engl. J. Med., August 16, 2001; 345(7): 517 - 525. [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Zisman, J. P. Lynch III, G. B. Toews, E. A. Kazerooni, A. Flint, and F. J. Martinez Cyclophosphamide in the Treatment of Idiopathic Pulmonary Fibrosis : A Prospective Study in Patients Who Failed To Respond to Corticosteroids Chest, June 1, 2000; 117(6): 1619 - 1626. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |