Interferon gamma-1b in the treatment of idiopathic pulmonary fibrosis.
OBJECTIVE
To examine the clinical aspects of idiopathic pulmonary fibrosis (IPF) and the efficacy and safety of interferon gamma-1b (IFNgamma-1b) in its treatment.


METHODS
Epidemiologic, preclinical, and clinical studies published in the English language were identified by a MEDLINE search (1966-January 2005) using the search terms idiopathic pulmonary fibrosis, cryptogenic fibrosing alveolitis, and interferon. Additional citations were identified from the reference lists of related publications.


METHODS
Selected preclinical studies describing the pathophysiologic basis for IFNgamma-1b therapy and all clinical studies were included. Additional trials describing other treatment modalities and the determinants of response to therapy in patients with IPF were also reviewed.


RESULTS
IFNgamma-1b targets the fibrotic rather than inflammatory processes of IPF. The efficacy of IFNgamma-1b in patients with IPF is inconsistent with regard to changes in pulmonary function and mortality, although a modest survival benefit was observed in the largest clinical trial. Adverse events related to IFNgamma-1b are frequent although transient. Several cases of respiratory failure occurring subsequent to the administration of IFNgamma-1b are documented.


CONCLUSIONS
To date, although trials suggest that earlier-stage IPF may be responsive to IFNgamma-1b, study results overall are inconsistent; further investigation is needed.
Pacanowski
Michael A
MA
Section of Clinical Pharmacology, Department of Pharmaceutical Care Services, Bassett Healthcare, Cooperstown, NY 13326-1394, USA.
Amsden
Guy W
GW
D002986:Clinical Trials as Topic; D006801:Humans; D007371:Interferon-gamma / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016239:MEDLINE; D011658:Pulmonary Fibrosis / Q000188:drug therapy* / Q000209:etiology; D011994:Recombinant Proteins; D016896:Treatment Outcome
D011994:Recombinant Proteins; D007371:Interferon-gamma