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Long-term clinical effects of interferon gamma-1b and colchicine in idiopathic pulmonary fibrosis

¹ Dept of Pneumonology, Medical School, University of Crete, Iráklion, Depts of ³ Pneumonology and, ⁶ Histopathology, Sotiria Chest Hospital, and, Depts of ⁴ Radiology and, ⁵ Pneumonology, Medical School, University of Athens, and, ⁷ Dept of Pneumonology, Sismanoglion Hospital, Athens, and, ⁸ Dept of Pneumonology, Democritus Medical School, University of Thrace, Alexandroúpolis, Greece. ² Dept of Histopathology, Royal Brompton Hospital, London, UK.

CORRESPONDENCE: D. Bouros, Medical School, Democritus University of Thrace, 68100, Alexandroupolis, Thrace, Greece. Fax: 30 2551076106. E-mail: bouros{at}med.duth.gr

Keywords: Colchicine, idiopathic pulmonary fibrosis, interferon gamma-1b, outcome, survival, treatment

Received: March 20, 2006
Accepted April 5, 2006

Idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia is a deadly disease with no effective treatment. The purpose of this randomised prospective multicentric study was to characterise the clinical effects of interferon gamma (IFN-) 1b administered subcutaneously thrice weekly versus colchicine for 2 yrs. This study had no pre-specified end-points.

Fifty consecutive IPF patients were randomised. Patients with mild-to-moderate IPF were eligible for the study if they had histologically proven IPF, or, in the absence of surgical biopsy, fulfilled the European Respiratory Society/American Thoracic Society criteria.

In the intent-to-treat population, five out of 32 (15.6%) IFN--1b patients and seven out of 18 (38.8%) colchicine patients died after a median follow-up period of 25 months Patients treated with IFN- 1b showed a better outcome after 2 yrs of therapy, and fewer symptoms, as assessed using the St George’s Respiratory Questionnaire, after 12 months of therapy. Also, the IFN--1b group exhibited a higher forced vital capacity (percentage of the predicted value) after 24 months of treatment. No significant differences were detected in resting arterial oxygen tension, total lung capacity (% pred), transfer factor of the lung for carbon monoxide (% pred) and high-resolution computed tomographic scoring between the two treatment groups.

These data suggest that long-term treatment with interferon gamma 1b may improve survival and outcome in patients with mild-to-moderate idiopathic pulmonary fibrosis. Further studies are needed to verify these results.

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