Cyclosporin A in the Treatment of Acute Exacerbation of Idiopathic Pulmonary Fibrosis
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概要
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Background Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) is considered to be a nearly fatal condition during the clinical course of IPF, as it is unresponsive to most conventional therapies. Subjects and Methods To evaluate the efficacy of cyclosporin A (CsA) for AE of IPF, we conducted a retrospective study on autopsied IPF cases who developed AE and were treated with corticosteroids (CS) combined with CsA. The subjects comprised 11 males with a mean age of 69.9 years. The clinical features and prognosis of the CsA-treated group was compared to a group of 11 autopsied IPF cases with a mean age of 68.7 years who developed AE and were treated with CS alone (non-CsA-treated group). Results CS pulse therapy followed by CS maintenance treatment were conducted in all cases of AE. Patients in the CsA-treated group received in addition a low dosage of CsA (100-150 mg). Although 7 out of 11 patients in the CsA-treated group died of AE per se, 4 patients survived the AE. Only 2 patients died during the first episode of AE. In comparison, 7 out of 11 patients in the non-CsA-treated group died during the first episode of AE. The mean survival period after the first onset of AE was 285 days in the CsA-treated group and 60 days in the non-CsA-treated group. The prognosis of the CsA-treated group therefore was significantly better than that of non-CsA-treated group after AE of IPF. Conclusion Administration of CsA combined with CS may be efficacious in the treatment of AE of IPF.
著者
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Homma Sakae
Division Of Respiratory Medicine Department Of Internal Medicine Toho University School Of Medicine
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Miyamoto Atsushi
Department Of Cardiovascular Medicine School Of Medicine Hokkaido University
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Yoshimura Kunihiko
Department Of Respiratory Medicine Respiratory Center Toranomon Hospital
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Kurosaki Atsuko
Department Of Diagnostic Radiology Toranomon Hospital
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Sakamoto Susumu
Division Of Respiratory Diseases Department Of Internal Medicine Jikei University School Of Medicine
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Fujii Takeshi
Department Of Applied Biological Science Faculty Of Science And Technology Science University Of Tok
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Homma Sakae
Division of Respiratory Medicine, Toho University School of Medicine, Toranomon Hospital
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