Abstract
Background and Aims: Corticosteroids was not recommended for idiopathic pulmonary fibrosis (IPF) by IPF guideline (AJRCCM 2011). However, impact of corticosteroids on idiopathic interstitial pneumonias (IIPs) with possible usual interstitial pneumonia (UIP) HRCT pattern (IIPs/HRCT possible UIP) remains to be solved and this is the aims of this study.
Subjects and Methods: Enrolled subjects of this trial were 98 cases with IIPs/HRCT possible UIP in our institute between 2005 and 2009: gender (M/F: 69/29), IPF/UIP (n=24) and Non-IPF (n=74), %FVC (median 80.6%) and %DLco (median 55.7%). Corticosteroids were introduced in 6 cases of IPF/UIP and 16 cases of Non-IPF. Impact of corticosteroids on IIPs/HRCT possible UIP was evaluated by Cox proportional hazard regression analysis.
Results: Survival of IPF/UIP and Non-IPF was similar (p=0.886, Log-rank test). Survival of corticosteroids treated cases was significantly worse than that of non-treated cases both in IPF/UIP (p=0.045) and in Non-IPF (p=0.019) (Log-rank test); however, impact of corticosteroids on survival of IIPs/HRCT possible UIP was not significant after adjustment with significant prognostic factors in all cases; %FVC, %DLco and Male. Corticosteroids were not a significant predictor of AE in IPF/UIP (p=0.215), but significant in Non-IPF (p=0.007) by Log-rank test. However, impact of corticosteroids on incidence of AE was not significant after adjustment with predictors of AE in all cases; %DLco and %FVC.
Conclusions: Corticosteroids did not alter the clinical course of IIPs/HRCT possible UIP.
Acknowledgement: This study is partially supported by grant of National Hospital Organization and Japanese Ministry of Health Labour and Welfare.
- Copyright ©the authors 2016
