Abstract
BACKGROUND: Agents that target pro-inflammatory cytokines and decreased oxidative stress may be useful in pulmonary sarcoidosis.
OBJECTIVE: To determine effectiveness of a non-selective cyclic nucleotide phosphodiesterase inhibitor, pentoxifylline (POF). At the same time POF is known to markedly reduce the release of TNF-alpha.
PURPOSE: To conduct retrospective analysis of clinical cases to determine whether the combination of POF (600-800 mg/day) and vitamin E (400 mg/day) given for 6-12 months effective in pulmonary sarcoidosis.
PATIENTS: 275 patients with biopsy-confirmed pulmonary sarcoidosis, 94 males and 1811 females, mean age 43.2±6.7 years. Radiological stages were 0 (1.8%), I (21,5%), II (68%), III (6.9%) and IV (1.8%), respectively.
RESULTS: The adverse events (headache, dizziness, abdominal pain, sleep disorders) was seen in 25.1%. No severe adverse effects were observed in any case. The symptomatic improvement was seen in 33.9% (deterioration in 19.2%). The objective improvement was noted in: 40% - radiological improvement (14.2% deterioration), 41.5% - FVC improvement (36.0% deterioration). Radiological stages after treatment were 0 (16%), I (17,8%), II (54.9%), III (8.7%) and IV (2.5%), respectively. In 85 pts (30.9%) sarcoidosis relapsed after PTX and vitamin E being withdrawn, and steroid therapy was introduced.
CONCLUSIONS: This investigation showed that the combined use of pentoxifylline and vitamin E leads to improvement or stabilization of pathologic process more than in 2/3 cases of newly diagnosed patients not previously treated with systemic corticosteroids.
- Copyright ©the authors 2016