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Efficacy of switching from cyclosporine A to tacrolimus in patients with refractory CTD-ILD

Yosuke Goto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka, Toshiaki Matsuda, Toshiki Yokoyama, Yasuhiko Yamano
European Respiratory Journal 2016 48: PA4878; DOI: 10.1183/13993003.congress-2016.PA4878
Yosuke Goto
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Hiroyuki Taniguchi
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Yasuhiro Kondoh
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Tomoki Kimura
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Kensuke Kataoka
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Toshiaki Matsuda
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Toshiki Yokoyama
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Yasuhiko Yamano
1Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, AichiJapan
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Abstract

Introduction: Both tacrolimus (Tac) and cyclosporine A (CsA) inhibit phosphatase calcineurin action through different intracellular receptors. Tac has up to a 100-fold stronger inhibitory effect on T cell activation and proliferation in vitro than CsA.

Aims: Our aim was to evaluate the efficacy of switching from CsA to Tac in patients with connective tissue disease-related interstitial lung disease (CTD-ILD) progressing despite combined therapy with prednisolone and CsA.

Methods: We retrospectively assessed the data of patients with CTD-ILD who were switched from CsA to Tac due to deterioration of lung disease between 2007 and 2014. Patients who had at least 3 months of data before and after switching therapy were enrolled in this study.

Results: A total of 12 patients, 6 (50%) polymyositis/dermatomyositis, 3 (25%) rheumatoid arthritis, 2 (17%) systemic sclerosis, and 1 (8%) mixed CTD were included in the analysis. Switching to Tac reduced declines in percentage predicted FVC (-5.0% vs. -0.1%; p=0.02) and diffusion capacity of carbon monoxide of the lung (-3.2% vs. -1.0%; p=0.16). The median change in St. George's Respiratory Questionnaire total score before and after switching to Tac were +5.6 and +1.4, respectively (p=0.27). Ten patients (83%) maintained a stable pulmonary function (%FVC<5% decline) after switching to Tac. This therapy was generally well-tolerated and no serious adverse events were observed.

Conclusions: In patients with CTD-ILD unresponsive to CsA, Tac may be an alternative therapeutic option.

  • Interstitial lung disease (connective tissue disease)
  • Interstitial lung disease
  • Treatments
  • Copyright ©the authors 2016
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Efficacy of switching from cyclosporine A to tacrolimus in patients with refractory CTD-ILD
Yosuke Goto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka, Toshiaki Matsuda, Toshiki Yokoyama, Yasuhiko Yamano
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4878; DOI: 10.1183/13993003.congress-2016.PA4878

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Efficacy of switching from cyclosporine A to tacrolimus in patients with refractory CTD-ILD
Yosuke Goto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka, Toshiaki Matsuda, Toshiki Yokoyama, Yasuhiko Yamano
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4878; DOI: 10.1183/13993003.congress-2016.PA4878
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