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Methylprednisolone plus prednisone, tacrolimus offers multidimensional therapeutic benefit in CTD-ILD

04 Nov 2018

Two courses of pulse dose methylprednisolone therapy followed by prednisolone and oral tacrolimus appear to be safe and effective in patients with connective tissue disease‐related interstitial lung disease (CTD-ILD), a recent study has shown.

A total of 26 ILD patients with underlying CTD diagnoses were included (11 with rheumatoid arthritis, nine with dermatomyositis, four with Sjögren's syndrome and two others).

From baseline to 12 months, forced vital capacity (FVC; 77.8–94.6 percent; p<0.001), diffusing capacity of the lung for carbon monoxide (DLCO; 66.1–75.1 percent; p<0.001), 6‐min walk distance (6MWD; 530–568 m; p=0.02), lowest oxygen saturation on pulse oximetry (SpO2; 85–89 percent; p=0.01), modified Medical Research Council (MMRC; 1.3–0.8; p=0.01) and St George's Respiratory Questionnaire (SGRQ; 38–21; p<0.001) significantly improved with the combined therapy.

Only one patient discontinued therapy due to an adverse event during the study period. None of the patients had a life-threatening adverse event attributed to the combined therapy.

This retrospective case series sought to examine the multidimensional therapeutic benefit and tolerability of the combined therapy for the initial treatment of patients with CTD-ILD.

The authors identified consecutive CTD-ILD patients treated with tacrolimus plus intravenous IV methylprednisolone (1,000 mg 3 days a week for 2 weeks) followed by low-dose prednisolone (10 mg/day). They evaluated the efficacy and tolerability including lung physiology, exercise capacity, exercise oxygen desaturation, MMRC and SGRQ.

“Corticosteroids and immunosuppressive agents are considered mainstays of therapy for CTD‐ILD; however, tacrolimus with corticosteroid therapy has not been fully investigated,” the authors said.

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Most Read Articles
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Dr Renly Lim, 01 Aug 2018
Palliative care uses an integrated, multidisciplinary approach to reduce suffering and to improve the quality of life of patients battling with life-threatening illnesses.
Rachel Soon, 24 Apr 2018

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Stephen Padilla, 20 Sep 2018
Romosozumab therapy for 12 months is well tolerated and effective in increasing spine and hip bone mineral density (BMD) in men with osteoporosis, according to a recent study.