Mycophenolate therapy in interstitial pneumonia with autoimmune features: a cohort study.

Abstract:

Objectives:International experts recently characterized interstitial pneumonia with autoimmune features (IPAF) as a provisional diagnosis for patients with interstitial lung disease who have characteristics of autoimmune disease but do not meet criteria for a specific autoimmune disease. We describe clinical characteristics of IPAF patients and examine responses to mycophenolate as a therapy for IPAF. Methods:This retrospective cohort included adult patients meeting European Respiratory Society/American Thoracic Society classification criteria for IPAF. Sociodemographic, clinical, and pulmonary function test data were abstracted for patients with and without mycophenolate treatment and followed longitudinally from interstitial lung disease diagnosis for change in pulmonary function test results. Results:We identified 52 patients who met criteria for IPAF. Of 52 IPAF patients, 24 did not receive mycophenolate and 28 did, with median time to mycophenolate treatment 22 months. Changes in FVC% and percentage predicted lung diffusion capacity for carbon monoxide (DLCO%) between the mycophenolate-treated and untreated groups were not significantly different (FVC% change P=0.08, DLCO% change P=0.17). However, there was a trend toward more rapid baseline decline of both FVC% and DLCO% in the mycophenolate-treated cohort before vs after mycophenolate therapy. The slope of both FVC% and DLCO% values improved after onset of mycophenolate exposure for the treated group, although this finding was not statistically significant. Conclusion:Patients with IPAF might benefit from mycophenolate therapy. Larger prospective clinical trials are needed to evaluate the efficacy of mycophenolate for patients who meet criteria for IPAF.

journal_name

Ther Clin Risk Manag

authors

McCoy SS,Mukadam Z,Meyer KC,Kanne JP,Meyer CA,Martin MD,Sampene E,Aesif SW,Rice LN,Bartels CM

doi

10.2147/TCRM.S173154

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

2171-2181

eissn

1176-6336

issn

1178-203X

pii

tcrm-14-2171

journal_volume

14

pub_type

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