title: Efficacy of combined therapy with cyclosporin and low-dose prednisolone in interstitial pneumonia associated with connective tissue disease.
abstract: BACKGROUND
  The optimal treatment method for interstitial pneumonia (IP) with connective tissue disease (CTD) remains controversial. In addition, a clinically meaningful end point to judge drug efficacy has not been fully investigated.
  
  
  OBJECTIVE
  The aim of this study was to evaluate, from various aspects, the therapeutic benefit and tolerability of combined therapy with cyclosporin A (CsA) and low-dose prednisolone (PSL) for chronic fibrosing CTD-IP patients.
  
  
  METHODS
  A total of 26 CTD-IP patients diagnosed by surgical lung biopsy and subsequently treated with the above combination therapy were retrospectively reviewed. The therapeutic regimen comprised methylprednisolone induction therapy for 2-4 weeks, followed by a combined therapy of CsA with low-dose PSL for 1 year. Evaluation of the therapeutic benefit was based on not only pulmonary function but also exercise capacity, health-related quality of life and dyspnea.
  
  
  RESULTS
  After 1 year of therapy, clinically significant improvements in forced vital capacity (≥10%), carbon monoxide diffusing capacity of the lung (≥15%), 6-min walk distance (≥28 m), and St. George's Respiratory Questionnaire (≤-7) were observed in 61.5, 69.2, 61.5 and 69.2% of the patients, respectively. All measurements showed statistically significant improvements compared with baseline values. The 1-year treatment did not need to be discontinued in any patients due to unacceptable toxicity, and no deaths occurred.
  
  
  CONCLUSIONS
  Combined therapy with CsA and low-dose PSL for CTD-IP patients was well-tolerated and patients displayed a noteworthy response.
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Watanabe
authors.forename: Koji
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kondoh
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kimura
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kataoka
authors.forename: Kenzo
authors.initials: K
authors.lastname: Ono
authors.forename: Junya
authors.initials: J
authors.lastname: Fukuoka
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishiyama
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hasegawa
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001706:Biopsy / Q000379:methods; D002908:Chronic Disease; D003240:Connective Tissue Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D004359:Drug Therapy, Combination / Q000379:methods; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007564:Japan; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D016572:Cyclosporine; D011239:Prednisolone