Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 121-127

Cyclosporine as a treatment in acutely exacerbated interstitial pneumonia: does it add value?

1 Department of Chest Diseases, Faculty of Medicine, Assiut University, Assiut, Egypt
2 Department of Internal Medicine & Molecular Therapeutics, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Egypt

Correspondence Address:
Reham El-morshedy
Department of Chest Diseases, Faculty of Medicine, Assiut University, Assiut, 71111
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-8426.145704

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Objective The aim of this study was to evaluate the efficacy of combined therapy of cyclosporine A (CsA) with prednisolone for acutely exacerbated interstitial pneumonia. Patients and method Forty-eight patients who were diagnosed as having interstitial pneumonia were recruited in the study. These patients experienced clinical worsening as demonstrated by any one of the following within the past year: greater than 10% decrease in the percent predicted forced vital capacity, worsening high-resolution CT scan or clinical worsening of dyspnea at rest or on exertion. CsA was given at a dose range of 2 mg/kg/day in addition to corticosteroids. Patients were assessed at baseline and then at 1, 3, 6, and 9 months for response to therapy and for any adverse effect of the treatment. Results Patients were divided according to the underlying systemic disease into either patients with idiopathic pulmonary fibrosis (25 patients) or those with underlying collagen vascular diseases (CVDs; 23 patients). Those with underlying CVDs were divided into either UIP/CVDs (five patients) or nonspecific interstitial pneumonia (NSIP/CVDs) (18 patients). Our results showed an overall better response in the NSIP/CVD group of patients. Follow-up parameters in 14 patients with an improved response showed an improved grade of dyspnea, improved partial pressure of oxygen (PaO 2 ), %forced vital capacity, and diffusing capacity of carbon monoxide (%DL CO ); Krebs von den Lungen 6 (KL6) showed a significant decrease after initiation of CsA treatment when compared with baseline. Furthermore, a benefit of adding CsA to the treatment was the ability to reduce the dose of steroids during the course of treatment.

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