Please use this identifier to cite or link to this item: http://repositorio.unifesp.br/handle/11600/28705
Title: Survival in idiopathic pulmonary fibrosis - cytotoxic agents compared to corticosteroids
Authors: Pereira, Carlos Alberto de Castro [UNIFESP]
Nunes, Tatiana Santos Malheiros [UNIFESP]
Coletta, Ester Nei Aparecida Martins [UNIFESP]
Ferreira, Rimarcs Gomes [UNIFESP]
Rubin, Adalberto Sperb
Ota-Arakaki, Jaquelina Sonoe [UNIFESP]
Rocha, Nailê Sena da [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Keywords: fibrosis
pulmonary
fibrosing alveolitis
cyclophosphamide
prednisone
Issue Date: 1-Feb-2006
Publisher: W B Saunders Co Ltd
Citation: Respiratory Medicine. London: W B Saunders Co Ltd, v. 100, n. 2, p. 340-347, 2006.
Abstract: Study objective: To compare the survival of patients with IPF treated retrospectively with corticosteroids atone, to survival of patients treated with immunosuppressive and corticosteroids combined. Design: Non-randomized retrospective cohort study.Setting: Three tertiary centers in Brazil.Patients: Eighty-two IPF patients were included. the diagnosis was confirmed by open lung biopsy in 48. Patients received either corticosteroids alone (group 1) or cytotoxic agents in addition to corticosteroids (group 11).Measurements and results: the primary end-point was mortality. Secondary outcome included longitudinal changes in FVC. Mean age was 66+8 years. FVC was 71 +/- 17% of predicted. There were 48 deaths during the study period (59%), 44 secondary to respiratory causes. From preliminary univariate analysis, for the group as a whole, worse survival was found to be associated with FVC% < 70% of predicted (P = 0.004), evidence of disease progression by follow-up FVC measurements (P = 0.01), and pharmacologic treatment (P = 0.014). Median survival was 25 months for the group 1, and 45 months for the group 11 (Log-Rank = 6.45, P = 0.01). After adjusting for FVC >= 70% and < 70% of predicted, there was evidence to indicate that survival was associated with recommended pharmacologic treatment only in patients with FVC >= 70% (Log Rank = 6.84, P = 0.009).Conclusions: the combination of immunosuppressive agents and prednisone results in better survival when compared to prednisone alone in patients with IPF the benefit seems to occur only in patients with less severe disease, as reflected by FVC >= 70%. (c) 2005 Elsevier B.V. All rights reserved.
URI: http://repositorio.unifesp.br/handle/11600/28705
ISSN: 0954-6111
Other Identifiers: http://dx.doi.org/10.1016/j.rmed.2005.05.008
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