Use of Mycophenolate Mofetil or Azathioprine for the Management of Chronic Hypersensitivity Pneumonitis
Use of Mycophenolate Mofetil or Azathioprine for the Management of Chronic Hypersensitivity Pneumonitis
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DOI：
10.1016/j.chest.2016.10.029
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发表时间：
2017-03-01
期刊：
影响因子：
9.6
通讯作者：
Ley, Brett
中科院分区：
文献类型：
--
作者：
Morisset, Julie;Johannson, Kerri A.;Ley, Brett
背景技术背景：慢性过敏性肺炎（cHP）的治疗通常包括全身口服皮质类固醇，但最佳的药物管理仍不清楚。与泼尼松相关的发病率促使人们寻找替代疗法。我们的目的是确定与霉酚酸酯（MMF）或硫唑嘌呤（AZA）对cHP患者的肺功能的治疗效果。方法：与cHP患者治疗与霉酚酸酯或AZA进行了回顾性确定从四个间质性肺病中心。使用线性混合效应模型（LMM），调整年龄，性别，吸烟史，和泼尼松use.RESULTS：70例患者进行了分析治疗开始前后肺功能的变化：51与MMF和19与AZA治疗。治疗开始后的中位随访时间为11个月。治疗前FVC和肺一氧化碳弥散量（DLCO）%预测值平均下降0.12%（P
BACKGROUND: The treatment of chronic hypersensitivity pneumonitis (cHP) often includes systemic oral corticosteroids, but the optimal pharmacologic management remains unclear. The morbidity associated with prednisone has motivated the search for alternative therapies. We aimed to determine the effect of treatment with mycophenolate mofetil (MMF) or azathioprine (AZA) on lung function in patients with cHP.METHODS: Patients with cHP treated with either MMF or AZA were retrospectively identified from four interstitial lung disease centers. Change in lung function before and after treatment initiation was analyzed using linear mixed-effects modeling (LMM), adjusting for age, sex, smoking history, and prednisone use.RESULTS: Seventy patients were included: 51 were treated withMMFand 19 with AZA. Median follow-up after treatment initiation was 11 months. Prior to treatment initiation, FVC and diffusion capacity of the lung for carbon monoxide (DLCO)% predicted were declining at amean rate of 0.12% (P