Colchicine versus prednisone as treatment of usual interstitial pneumonia.
OBJECTIVE
To assess the results with colchicine and prednisone as initial single-drug therapy in patients with usual interstitial pneumonia (UIP).


METHODS
We reviewed the serial pulmonary function test results in 22 patients with typical clinical and high-resolution computed tomographic features of UIP who were treated with colchicine as initial single-agent therapy and compared them with a group of 22 historical patients with UIP of similar severity diagnosed by open-lung biopsy who were given prednisone as initial single-drug therapy.


RESULTS
No significant difference was detected in the rate of decline of pulmonary function or in the time to "failure" between the two study groups. A trend was suggested for more rapid decline of pulmonary function in the prednisone-treated than in the colchicine-treated group. The design of this study does not allow distinction between a possible beneficial effect of colchicine and a possible adverse effect related to weaning from high-dose prednisone. Colchicine was well tolerated; few side effects other than mild diarrhea were noted in those patients able to take the drug long enough to return for pulmonary function testing at 3 months. In comparison, the side effects of prednisone were more serious and were not always reversible with cessation of therapy.


CONCLUSIONS
This study lends further support to the assumption that colchicine may be a satisfactory and less hazardous substitute for prednisone in the treatment of patients with UIP.
Douglas
W W
WW
Division of Pulmonary and Critical Care Medicine and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905, USA.
Ryu
J H
JH
Bjoraker
J A
JA
Schroeder
D R
DR
Myers
J L
JL
Tazelaar
H D
HD
Swensen
S J
SJ
Scanlon
P D
PD
Peters
S G
SG
DeRemee
R A
RA
D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003078:Colchicine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D011658:Pulmonary Fibrosis / Q000188:drug therapy / Q000503:physiopathology; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003078:Colchicine; D011241:Prednisone