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Previous Volume 341:1264-1269 October 21, 1999 Number 17 Next

	Full Text PDF Editorial by du Bois, R.M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article PubMed Citation

ABSTRACT

Background Patients with idiopathic pulmonary fibrosis have progressive scarring of the lung and usually die within four to five years after symptoms develop. Treatment with oral glucocorticoids is often ineffective. We conducted an open, randomized trial of treatment with a combination of interferon gamma-1b, which has antifibrotic properties, and an oral glucocorticoid.

Methods We studied 18 patients with idiopathic pulmonary fibrosis who had not had responses to glucocorticoids or other immunosuppressive agents. Nine patients were treated for 12 months with oral prednisolone alone (7.5 mg daily, which could be increased to 25 to 50 mg daily), and nine with a combination of 200 µg of interferon gamma-1b (given three times per week subcutaneously) and 7.5 mg of prednisolone (given once a day).

Results All the patients completed the study. Lung function deteriorated in all nine patients in the group given prednisolone alone: total lung capacity decreased from a mean (±SD) of 66±8 percent of the predicted value at base line to 62±6 percent at 12 months. In contrast, in the group receiving interferon gamma-1b plus prednisolone, total lung capacity increased (from 70±6 percent of the predicted value at base line to 79±12 percent at 12 months, P<0.001 for the difference between the groups). In the group that received interferon gamma-1b plus prednisolone, the partial pressure of arterial oxygen at rest increased from 65±9 mm Hg at base line to 76±8 mm Hg at 12 months, whereas in the group that received prednisolone alone it decreased from 65±6 to 62±4 mm Hg (P<0.001 for the difference in the change from base-line values between the two groups); on maximal exertion, the value increased from 55±6 to 65±8 mm Hg in the group that received combined treatment and decreased from 55±6 mm Hg to 52±5 mm Hg in the group given prednisolone alone (P<0.001). The side effects of interferon gamma-1b, such as fever, chills, and muscle pain, subsided within the first 9 to 12 weeks.

Conclusions In a preliminary study, 12 months of treatment with interferon gamma-1b plus prednisolone was associated with substantial improvements in the condition of patients with idiopathic pulmonary fibrosis who had had no response to glucocorticoids alone.

Source Information

From the Department of Internal Medicine IV, Division of Pulmonary Medicine, University of Vienna Medical School, Vienna, Austria.

Address reprint requests to Dr. Block at the University of Vienna Medical School, Wahringer Gurtel 18-10, A-1090 Vienna, Austria, or at lutz-henning.block{at}akh-wein.ac.at.

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Interferon Gamma-1b for the Treatment of Idiopathic Pulmonary Fibrosis
King T. E., Ziesche R., Block L.-H., Bois R.M. d.
Extract | Full Text  
N Engl J Med 2000; 342:974-975, Mar 30, 2000. Correspondence

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