Recombinant thrombomodulin safely improves acute exacerbation in idiopathic interstitial pneumonias
Recombinant human soluble thrombomodulin (rhTM) is a safe and effective treatment for acute exacerbation (AE) in other idiopathic interstitial pneumonias (IIP), a recent study has shown.
AE-IIP patients treated with rhTM had a 90-day survival rate of 66.7 percent (26/39), while those who were not treated with rhTM had a survival rate of 47.5 percent (29/61). After adjusting for imbalances, a significant association was found between rhTM therapy and reduced mortality (adjusted hazard ratio, 0.453, 95 percent CI, 0.237–0.864; p=0.0163).
Adverse events occurred in 17.9 percent (7/39) of patients treated with rhTM and in 19.7 percent (12/61) of those who did not receive rhTM, which were comparable in both groups (p=1.0). In addition, the rhTM group reported two cases of bleeding events.
Future randomized controlled trials are warranted to confirm these findings.
This prospective, single-arm, open-label, multicentre cohort study retrospectively registered 61 patients with AE-IIP who were treated with conventional therapy between 2011 and 2013 (control group) and prospectively included 39 patients with AE-IIP who received conventional therapy and rhTM (380 U/kg/day for 6 days) between 2014 and 2016 (rhTM group).
The investigators conducted an adjusted mortality analysis for 90-day survival with weighted Cox proportional regression models using inverse probability of treatment weighting to reduce potential confounding in treatment comparisons. Weights were derived from propensity score estimated using a multivariable logistic regression analysis, including potential confounders.
“AE in idiopathic pulmonary fibrosis or other IIP is a poor prognostic event despite conventional therapy with corticosteroids and/or immunosuppressants,” the investigators said.