Efficacy of corticosteroid and intravenous cyclophosphamide in acute exacerbation of idiopathic pulmonary fibrosis: A propensity score-matched analysis

Respirology : Official Journal of the Asian Pacific Society of Respirology
Hironao HozumiTakafumi Suda

Abstract

Acute exacerbation (AE) is a leading cause of death in patients with idiopathic pulmonary fibrosis (IPF). Although optimal treatment for AE-IPF remains unclear, high-dose corticosteroids (CS) with/without immunosuppressants, including intravenous cyclophosphamide (IVCY), are often used as empirical therapy. However, the survival benefit of adding IVCY to CS therapy is unknown. We investigated the efficacy of this therapy in patients with AE-IPF. Overall, 102 consecutive patients with IPF with a first idiopathic AE were included. Post-AE survival rates and treatment safety were retrospectively assessed. Efficacy of CS + IVCY therapy for the first AE was compared with that of CS monotherapy using a propensity score-matched analysis. The post-AE 90-day survival rate of the entire cohort was 64.7%. On the basis of the propensity scores, 26 matched patient pairs were made. Characteristics of matched patients with AE-IPF treated with CS (matched CS group) and those with CS + IVCY (matched CS + IVCY group) were well balanced. No significant between-group differences were observed in post-AE 90-day survival rates (84.6% vs 76.9%; P = 0.70), cumulative survival rates (P = 0.57 by log-rank test) or incidence of adverse events ≥ CTCAE (Co...Continue Reading

References

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Citations

Jun 19, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Athol U Wells
Jan 30, 2020·Expert Review of Respiratory Medicine·Davide BiondiniPaolo Spagnolo
Mar 19, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·Peter M George, Athol U Wells
Aug 20, 2020·Molecular and Cellular Biochemistry·Ting ZhuGuangmao Yu
Dec 15, 2020·Current Pulmonology Reports·Tejaswini Kulkarni, Steven R Duncan
Aug 11, 2021·Pneumologie·Markus PolkeMichael Kreuter
Sep 11, 2021·The Lancet. Respiratory Medicine·Jean-Marc NaccacheUNKNOWN EXAFIP investigators and the OrphaLung network

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