Benefit of adjunctive tacrolimus in connective tissue disease-interstitial lung disease. Pulm Pharmacol Ther 2016 Feb;36:46-52
Date
01/15/2016Pubmed ID
26762710Pubmed Central ID
PMC4760686DOI
10.1016/j.pupt.2015.12.004Scopus ID
2-s2.0-84957702993 (requires institutional sign-in at Scopus site) 34 CitationsAbstract
We evaluated the safety and effectiveness of adjunctive tacrolimus therapy with conventional immunosuppression in patients with severe connective tissue disease-related interstitial lung disease (CTD-ILD). We included patients from our interstitial lung disease (ILD) registry with CTD-ILD, in whom tacrolimus was added to corticosteroids and an additional immunosuppressive agent. Demographic data, clinical features, lung function, radiographic images, and pathologic findings were reviewed. Effectiveness was assessed by comparing pulmonary function tests (PFTs) closest to tacrolimus initiation to PFTs approximately 6-12 months later. Corticosteroid dose at these time points was also evaluated. We report adverse events attributed to tacrolimus. Seventeen patients with CTD-ILD were included in adverse event analysis; twelve were included in efficacy analysis. Length of tacrolimus therapy ranged from 6 to 110 months (mean 38.8 months ± 31.4). The mean improvement in percent predicted total lung capacity was 7.5% ± 11.7 (p = 0.02). Forced vital capacity mean improvement was 7.4% ± 12.5 (p = 0.06). The average decrease in corticosteroid dose at follow-up was 20.3 mg ± 25.2 (p = 0.02) with complete discontinuation in six patients. No patients experienced a life-threatening adverse event attributed to tacrolimus. Tacrolimus can be effective and is well tolerated as an adjunctive therapy and allows tapering of corticosteroids.
Author List
Witt LJ, Demchuk C, Curran JJ, Strek MEAuthor
Carley Demchuk MD Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Adrenal Cortex HormonesAdult
Aged
Anti-Inflammatory Agents
Connective Tissue Diseases
Dermatomyositis
Drug Therapy, Combination
Female
Humans
Immunosuppressive Agents
Lung Diseases, Interstitial
Male
Middle Aged
Monitoring, Physiologic
Radiography
Respiratory Function Tests
Retrospective Studies
Tacrolimus
Total Lung Capacity
Treatment Outcome
Vital Capacity
