Intravenous immunoglobulin for acute exacerbation of fibrotic idiopathic interstitial pneumonias.

IF 1.4 4区医学 Q4 RESPIRATORY SYSTEM

Sarcoidosis, Vasculitis, and Diffuse Lung Diseases Pub Date : 2022-12-19 DOI:10.36141/svdld.v39i4.13682

Hisao Higo, Hirohisa Ichikawa, Naoki Nakamura, Masanori Fujii, Katsuhiro Matsuoka, Shoko Seki, Takamasa Wada, Noriyuki Suzaki, Takuya Nagata, Yukako Arakawa, Yoshihiro Mori, Masaomi Marukawa, Katsuyuki Kiura, Yoshinobu Maeda, Nobuaki Miyahara

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引用次数: 0

Abstract

Background and aim: Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) is a fatal condition with no established treatment. Intravenous immunoglobulin (IVIG) is a unique therapy with both anti-inflammatory and anti-infective effects. Therefore, we hypothesized that IVIG may have a positive effect on AE of interstitial pneumonia. This study aimed to determine the effect of IVIG in patients with AE of fibrotic idiopathic interstitial pneumonias (IIPs), including IPF.

Methods: We retrospectively analyzed consecutive patients who were diagnosed with AE of fibrotic IIPs and treated with pulse corticosteroid therapy (methylprednisolone 500-1000 mg/day for 3 days) between April 2018 and May 2021 at Kagawa Rosai Hospital and KKR Takamatsu Hospital.

Results: This study included 52 patients with AE of fibrotic IIPs (IPF,41; fibrotic IIPs other than IPF,11). Thirteen patients received IVIG (5 g/day for 3-5 days) concurrently with pulse corticosteroid therapy. The remaining 39 patients were assigned to the control group. The survival rate on day 90 was significantly higher in the IVIG group than that in the control group (76.9% vs. 38.5%, p = 0.02). IVIG administration (odds ratio [OR], 0.11; 95% confidence interval [CI], 0.02-0.69; p = 0.02) and C- reactive protein (OR, 1.19; 95% CI, 1.06-1.33, p < 0.01) were independently associated with 90-day mortality.

Conclusions: The results indicate that administration of IVIG may improve the survival of patients with AE of fibrotic IIPs. We are now conducting a prospective study to confirm the effect of IVIG on AE of IPF since May 2022 (jRCT1061220010).

Abstract Image

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静脉注射免疫球蛋白治疗纤维化特发性间质性肺炎急性加重。

背景和目的:特发性肺纤维化(IPF)急性加重(AE)是一种致命的疾病，目前尚无成熟的治疗方法。静脉注射免疫球蛋白(IVIG)是一种具有抗炎和抗感染作用的独特疗法。因此，我们推测IVIG可能对间质性肺炎AE有积极作用。本研究旨在确定IVIG对包括IPF在内的AE型纤维化特发性间质性肺炎(IIPs)患者的影响。方法:回顾性分析2018年4月至2021年5月在香川罗赛医院和KKR高松医院诊断为纤维化IIPs AE并接受脉搏皮质类固醇治疗(甲基强的松龙500-1000 mg/天，持续3天)的连续患者。结果:本研究纳入52例纤维化IIPs AE患者(IPF,41例;除IPF外的纤维化IIPs,11)。13例患者同时接受IVIG (5 g/天，持续3-5天)和脉搏皮质类固醇治疗。其余39例患者作为对照组。IVIG组第90天生存率显著高于对照组(76.9% vs. 38.5%， p = 0.02)。IVIG给药(优势比[OR]， 0.11;95%置信区间[CI]， 0.02-0.69;p = 0.02)和C-反应蛋白(OR, 1.19;95% CI, 1.06-1.33, p < 0.01)与90天死亡率独立相关。结论:应用IVIG可提高纤维化IIPs AE患者的生存率。我们目前正在进行一项前瞻性研究，以确认自2022年5月起IVIG对IPF AE的影响(jRCT1061220010)。

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来源期刊

Sarcoidosis, Vasculitis, and Diffuse Lung Diseases 医学-呼吸系统

CiteScore

2.20

自引率

6.20%

发文量

期刊介绍： Sarcoidosis Vasculitis and Diffuse Lung Disease is a quarterly journal founded in 1984 by G. Rizzato. Now directed by R. Baughman (Cincinnati), P. Rottoli (Siena) and S. Tomassetti (Forlì), is the oldest and most prestigious Italian journal in such field.