Cyclophosphamide with low or high dose prednisolone for systemic sclerosis lung disease
Φόρτωση...
Ημερομηνία
Συγγραφείς
Pakas, I.
Ioannidis, J. P.
Malagari, K.
Skopouli, F. N.
Moutsopoulos, H. M.
Vlachoyiannopoulos, P. G.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
J Rheumatol
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE: To evaluate the safety and efficacy of monthly intravenous pulses of cyclophosphamide (CP) in combination with low or high doses of prednisolone in patients with systemic sclerosis (SSc) related interstitial lung disease (ILD) with FVC < 70% of predicted. METHODS: An open label, non-parallel arm study, performed in the rheumatology outpatient clinic of a university hospital. Twenty-eight patients with SSc related ILD were evaluated. Endpoint evaluations included the evolution of high resolution computed tomography, pulmonary function tests, skin involvement and dyspnea over 12 months. Patients were treated with monthly IV CP in combination with prednisolone at low (< 10 mg/day; n = 12) or high doses (1 mg/kg/day for 4 weeks, then reducing the prednisolone by 5 mg/day on alternating days each 2 weeks; n = 16). RESULTS: In the low dose steroid group, no improvement was seen for any endpoint at 6 and 12 months of followup. In the high dose steroid group, at 12 months there was significant improvement in the percentage of "ground glass" parenchymal lung involvement (-5.7%; p = 0.003), as well as in the percentage of predicted FVC (12.4%; p < 0.001), the percentage of predicted DLCO (7.3%; p = 0.029), the percentage of skin involvement (-5.4%; p = 0.01), and the severity of dyspnea (p = 0.012). Substantial improvement was seen as early as 6 months. One patient (low dose group) died from ILD. CONCLUSION: A combination of IV pulse CP with high doses of prednisolone shows promising efficacy in improving the clinical, physiological, and radiological evolution of SSc related ILD with reversal of the underlying alveolitis.
Περιγραφή
Λέξεις-κλειδιά
Ambulatory Care, Anti-Inflammatory Agents/analysis/*therapeutic use, Cyclophosphamide/*therapeutic use, Dose-Response Relationship, Drug, Drug Therapy, Combination, Dyspnea/drug therapy/etiology/physiopathology, Female, Hospitals, University, Humans, Immunosuppressive Agents/*therapeutic use, Injections, Intravenous, Lung/physiopathology/radiography, Male, Middle Aged, Prednisolone/administration & dosage/*therapeutic use, Prospective Studies, Pulmonary Fibrosis/complications/*drug therapy/physiopathology, Pulse Therapy, Drug, Respiratory Function Tests, Scleroderma, Systemic/complications/*drug therapy/physiopathology, Tomography, X-Ray Computed, Treatment Outcome
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/11842824
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής