Usefulness of cyclosporine A on rapidly progressive interstitial pneumonia in dermatomyositis.
BACKGROUND
Interstitial pneumonia in polymyositis and dermatomyositis (PM/DM) is recognized to be a major complication of PM/DM. Rapidly progressive interstitial pneumonia (RPIP) in DM is frequently refractory to steroids and is the prognosis-determining factor in DM. Recently cyclosporine A (CyA) has emerged as an available treatment for interstitial pneumonia in PM/DM, but its efficacy on RPIP is unclear.


OBJECTIVE
To evaluate the usefulness of CyA in the treatment of RPIP in DM.


METHODS
We reviewed the medical charts of 10 cases with RPIP in DM to whom CyA was administered.


CONCLUSIONS
Combined administration of oral CyA and steroids with/without immuno-suppressants was likely to be beneficial in 4 of 10 cases that were refractory to the conventional preceding therapy. The values of PaO2/FIO2 when CyA were initiated were suggested to be a prognosis-determining factor for the outcome of the disease, showing that initiation of CyA should be considered in the early stage of RPIP in DM. The dosage of steroids was tapered in 3 out of 4 CyA-responsive cases without re-exacerbation. Therefore administration of CyA might be useful in lowering the dosage of steroids.
Miyake
Shuji
S
Pulmonary Medicine, Tokyo Medical and Dental University, Japan.
Ohtani
Yoshio
Y
Sawada
Megumi
M
Inase
Naohiko
N
Miyazaki
Yasunari
Y
Takano
Shogo
S
Miyasaka
Nobuyuki
N
Yoshizawa
Yasuyuki
Y
D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use*; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide; D011239:Prednisolone; D008775:Methylprednisolone