J Mankikian1, O Favelle2, A Guillon3, L Guilleminault4, B Cormier5, A P Jonville-Béra6, D Perrotin7, P Diot4, S Marchand-Adam8. 1. CHRU Tours, Service de Pneumologie, Tours, France. 2. CHRU Tours, Service de Radiologie, Tours, France. 3. Université François Rabelais, UMR 1100, F-37032 Tours, France; INSERM, Centre d'Etude des Pathologies Respiratoires, UMR 1100/EA6305, F-37032 Tours, France; CHRU Tours, Service de Réanimation Médicale, Tours, France. 4. CHRU Tours, Service de Pneumologie, Tours, France; Université François Rabelais, UMR 1100, F-37032 Tours, France; INSERM, Centre d'Etude des Pathologies Respiratoires, UMR 1100/EA6305, F-37032 Tours, France. 5. CHRU Tours, Service d'anatomopathologie, Tours, France. 6. CHRU Tours, Service de Pharmacologie Clinique Centre Régional de Pharmacovigilance, Tours, France. 7. Université François Rabelais, UMR 1100, F-37032 Tours, France; CHRU Tours, Service de Réanimation Médicale, Tours, France. 8. CHRU Tours, Service de Pneumologie, Tours, France; Université François Rabelais, UMR 1100, F-37032 Tours, France; INSERM, Centre d'Etude des Pathologies Respiratoires, UMR 1100/EA6305, F-37032 Tours, France. Electronic address: karoun@orange.fr.
Abstract
UNLABELLED: Amiodarone-induced pulmonary toxicity (APT) is a serious adverse event that can lead to death. The aims of our study are to determine factors associated with mortality and to describe outcome and sequelae of patients with APT. METHODS: Forty-six patients with APT were divided into two groups according to survival at day 90 for a clinical, functional, biological and radiological comparaison. We then evaluated the evolution of 15 survivors at a median of three months [1-6 months] and/or 12 months [8-36 months]. RESULTS: Mortality of APT at day 90 was 37% (17 patients) and was linked to the speed of onset of symptoms and a high HRCT alveolar score. Angiotensin system antagonist treatment was prescribed significantly more in the survival group (p = 0.042, HR 0.34 (95% CI 0.12-0.96)). In surviving patients, dyspnea, vital capacity and HRCT alveolar score improved significantly while HRCT fibrosis score deteriorated gradually during the first six months. At the end of the study, all the surviving patients presented functional and/or radiological sequelae. CONCLUSIONS: Severity of APT is linked to the extent and speed of onset of pulmonary damage. After the initial episode, the patients who survived improved slowly but with persistent sequelae.
UNLABELLED: Amiodarone-induced pulmonary toxicity (APT) is a serious adverse event that can lead to death. The aims of our study are to determine factors associated with mortality and to describe outcome and sequelae of patients with APT. METHODS: Forty-six patients with APT were divided into two groups according to survival at day 90 for a clinical, functional, biological and radiological comparaison. We then evaluated the evolution of 15 survivors at a median of three months [1-6 months] and/or 12 months [8-36 months]. RESULTS: Mortality of APT at day 90 was 37% (17 patients) and was linked to the speed of onset of symptoms and a high HRCT alveolar score. Angiotensin system antagonist treatment was prescribed significantly more in the survival group (p = 0.042, HR 0.34 (95% CI 0.12-0.96)). In surviving patients, dyspnea, vital capacity and HRCT alveolar score improved significantly while HRCT fibrosis score deteriorated gradually during the first six months. At the end of the study, all the surviving patients presented functional and/or radiological sequelae. CONCLUSIONS: Severity of APT is linked to the extent and speed of onset of pulmonary damage. After the initial episode, the patients who survived improved slowly but with persistent sequelae.
Authors: Sarah Skeoch; Nicholas Weatherley; Andrew J Swift; Alexander Oldroyd; Christopher Johns; Conal Hayton; Alessandro Giollo; James M Wild; John C Waterton; Maya Buch; Kim Linton; Ian N Bruce; Colm Leonard; Stephen Bianchi; Nazia Chaudhuri Journal: J Clin Med Date: 2018-10-15 Impact factor: 4.241
Authors: Arlene Tave; Earl Goehring; Vibha Desai; Chuntao Wu; Rhonda L Bohn; Sally G Tamayo; Nicholas Sicignano; Juhaeri Juhaeri; Judith K Jones; Sheila R Weiss Journal: Pharmacoepidemiol Drug Saf Date: 2021-05-04 Impact factor: 2.890