Multidimensional improvement in connective tissue disease-associated interstitial lung disease: Two courses of pulse dose methylprednisolone followed by low-dose prednisone and tacrolimus

Respirology : Official Journal of the Asian Pacific Society of Respirology
Yasuhiko YamanoYoshinori Hasegawa

Abstract

Corticosteroids and immunosuppressive agents are considered mainstays of therapy for connective tissue disease-related interstitial lung disease (CTD-ILD); however, tacrolimus with corticosteroid therapy has not been fully investigated. Our objectives were to examine the multidimensional therapeutic benefit and tolerability of the combined therapy for the initial treatment of patients with CTD-ILD. In this retrospective case series, we identified consecutive CTD-ILD patients treated with tacrolimus plus intravenous (i.v.) methylprednisolone (1000 mg i.v. 3 days a week for 2 weeks) followed by low-dose prednisolone (10 mg/day). We assessed the multidimensional therapeutic benefit and tolerability including lung physiology, exercise capacity, exercise oxygen desaturation, modified Medical Research Council (MMRC) and St George's Respiratory Questionnaire (SGRQ). A total of 26 ILD patients with the underlying CTD diagnoses included 11 with rheumatoid arthritis, 9 with dermatomyositis, 4 with Sjögren's syndrome and 2 others. From baseline to 12 months, the combined therapy significantly improved forced vital capacity (FVC; 77.8% to 94.6%, P < 0.001), diffusing capacity of the lung for carbon monoxide (DLCO ; 66.1% to 75.1%, P < 0.00...Continue Reading

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Citations

Aug 22, 2018·Respirology : Official Journal of the Asian Pacific Society of Respirology·Margaret Wilsher
May 9, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Pier-Valerio MariLuca Richeldi
Mar 7, 2020·Current Opinion in Rheumatology·Bryant R England, Daniel Hershberger
Nov 9, 2019·PloS One·Pablo Guisado-VascoAlarico Ariani
Jun 27, 2020·Pathogens·Vipul K SinghArshad Khan
Apr 16, 2020·Journal of Clinical Medicine·Giulia CassoneMarco Sebastiani
Jun 26, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·Suha Kadura, Ganesh Raghu
Jul 3, 2021·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Aliye Gediz ErturkTuba Yildirim
Dec 16, 2021·Expert Opinion on Pharmacotherapy·Alessia ComesLuca Richeldi

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