PMID- 36863306
OWN - NLM
STAT- MEDLINE
DCOM- 20230424
LR  - 20230424
IS  - 2212-5353 (Electronic)
IS  - 2212-5345 (Linking)
VI  - 61
IP  - 3
DP  - 2023 May
TI  - Interstitial pneumonia with autoimmune features and histologic usual interstitial 
      pneumonia treated with anti-fibrotic versus immunosuppressive therapy.
PG  - 297-305
LID - S2212-5345(23)00016-3 [pii]
LID - 10.1016/j.resinv.2023.01.007 [doi]
AB  - BACKGROUND: Therapeutic strategies in patients with interstitial pneumonia with 
      autoimmune features (IPAF) and histological usual interstitial pneumonia (UIP) 
      pattern (IPAF-UIP) have not been thoroughly evaluated. We compared the 
      therapeutic efficacy of anti-fibrotic therapy with that of immunosuppressive 
      treatment for patients with IPAF-UIP. METHODS: In this retrospective case series, 
      we identified consecutive IPAF-UIP patients treated with anti-fibrotic therapy or 
      immunosuppressive therapy. Clinical characteristics, one-year treatment response, 
      acute exacerbation, and survival were studied. We performed a stratified analysis 
      by the pathological presence or absence of inflammatory cell infiltration. 
      RESULTS: Twenty-seven patients with anti-fibrotic therapy and 29 with 
      immunosuppressive treatment were included. There was a significant difference in 
      one-year forced vital capacity (FVC) change between patients with anti-fibrotic 
      treatment (4 in 27 improved, 12 stable, and 11 worsened) and those with 
      immunosuppressive treatment (16 in 29 improved, eight stable, and five worsened) 
      (p = 0.006). There was also a significant difference in one-year St George's 
      Respiratory Questionnaire (SGRQ) change between patients with anti-fibrotic 
      therapy (2 in 27 improved, ten stable, and 15 worsened) and those with 
      immunosuppressive treatment (14 in 29 improved, 12 stable, and worsened) 
      (p < 0.001). There was no significant difference in survival between the groups 
      (p = 0.32). However, in the subgroup with histological inflammatory cell 
      infiltration, survival was significantly better with immunosuppressive therapy 
      (p = 0.02). CONCLUSION: In IPAF-UIP, immunosuppressive therapy seemed to be 
      superior to anti-fibrotic treatment in terms of therapeutic response, and 
      provided better outcomes in the histological inflammatory subgroup. Further 
      prospective studies are needed to clarify the therapeutic strategy in IPAF-UIP.
CI  - Copyright (c) 2023. Published by Elsevier B.V.
FAU - Yamano, Yasuhiko
AU  - Yamano Y
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan.
FAU - Kataoka, Kensuke
AU  - Kataoka K
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan.
FAU - Takei, Reoto
AU  - Takei R
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan.
FAU - Sasano, Hajime
AU  - Sasano H
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan.
FAU - Yokoyama, Toshiki
AU  - Yokoyama T
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan.
FAU - Matsuda, Toshiaki
AU  - Matsuda T
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan.
FAU - Kimura, Tomoki
AU  - Kimura T
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan.
FAU - Mori, Yuta
AU  - Mori Y
AD  - Department of Respiratory Medicine, Nagoya University Graduate School of 
      Medicine, Aichi, Japan.
FAU - Furukawa, Taiki
AU  - Furukawa T
AD  - Center for Healthcare Information Technology (C-HiT), Nagoya University, Aichi, 
      Japan.
FAU - Fukuoka, Junya
AU  - Fukuoka J
AD  - Department of Laboratory of Pathology, Nagasaki University Hospital, Nagasaki, 
      Japan.
FAU - Johko, Takeshi
AU  - Johko T
AD  - Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan.
FAU - Kondoh, Yasuhiro
AU  - Kondoh Y
AD  - Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, 
      Aichi, Japan. Electronic address: konyasu2003@yahoo.co.jp.
LA  - eng
PT  - Journal Article
DEP - 20230228
PL  - Netherlands
TA  - Respir Investig
JT  - Respiratory investigation
JID - 101581124
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - *Autoimmune Diseases/drug therapy
MH  - *Lung Diseases, Interstitial/pathology
MH  - *Idiopathic Pulmonary Fibrosis
MH  - Immunosuppressive Agents/therapeutic use
MH  - Immunosuppression Therapy
OTO - NOTNLM
OT  - Collagen vascular diseases
OT  - Immunosuppressive therapy
OT  - Interstitial lung diseases
OT  - Interstitial pneumonia with autoimmune features
OT  - Usual interstitial pneumonia
COIS- Conflict of Interest Dr. Kondoh and Dr. Kataoka have received fees fromBoehringer 
      Ingelheim Co., Ltd. that were unrelated to the present work. The authors have no 
      other conflicts of interest to declare.
EDAT- 2023/03/03 06:00
MHDA- 2023/04/24 06:42
CRDT- 2023/03/02 18:21
PHST- 2022/06/21 00:00 [received]
PHST- 2022/12/14 00:00 [revised]
PHST- 2023/01/06 00:00 [accepted]
PHST- 2023/04/24 06:42 [medline]
PHST- 2023/03/03 06:00 [pubmed]
PHST- 2023/03/02 18:21 [entrez]
AID - S2212-5345(23)00016-3 [pii]
AID - 10.1016/j.resinv.2023.01.007 [doi]
PST - ppublish
SO  - Respir Investig. 2023 May;61(3):297-305. doi: 10.1016/j.resinv.2023.01.007. Epub 
      2023 Feb 28.