Nicolas Petitpierre1, Vincent Cottin2, Sylvain Marchand-Adam3, Sandrine Hirschi4, Dominique Rigaud5, Isabelle Court-Fortune6, Stéphane Jouneau7, Dominique Israël-Biet8, Anita Molard4, Jean-François Cordier2, Romain Lazor1,2. 1. Interstitial and rare lung diseases Unit, Department of Respiratory Medicine, Lausanne University Hospital, Lausanne, Switzerland. 2. Department of Respiratory Medicine and Reference Center for rare lung diseases, Lyon University Hospital, Lyon, France. 3. Department of Respiratory Medicine, Tours University Hospital, Tours, France. 4. Department of Respiratory Medicine, Strasbourg University Hospital, Strasbourg, France. 5. Respiratory physician, Private practice, Grenoble, France. 6. Department of Respiratory Medicine, St-Etienne University Hospital, St-Etienne, France. 7. Department of Respiratory Medicine, Competences center for rare pulmonary diseases, IRSET UMR 1085, Rennes 1 University, Rennes University Hospital, Rennes, France. 8. Department of Respiratory Medicine, Georges-Pompidou European Hospital, Paris, France.
Abstract
Background: Some data suggest that anti-inflammatory macrolides may be effective to treat organizing pneumonia (OP) and prevent relapses, but no formal comparison with prednisone alone is available. To explore this issue, we retrospectively compared the efficacy of a 12-week combined regimen of clarithromycin and prednisone with a 24-week prednisone alone regimen in OP. Methods: A standard 12-week regimen of combined clarithromycin and prednisone was designed for the treatment of cryptogenic or radiation-induced OP, aiming at reducing the cumulated prednisone dose and the relapse rate. Its use was left to the discretion of the treating physicians, members of the Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires. Data were compared to a historical control group treated with a standard 24-week prednisone alone regimen. Results: 16 patients were treated with combined therapy and 21 with prednisone alone. Complete radiological remission was achieved in 63% of the combined therapy group and 81% of the prednisone alone group (p=0.38). Symptomatic relapses occurred in 81% of the combined therapy group, and 52% of the prednisone alone group (p=0.14). No side effect of clarithromycin was reported. Conclusions: In patients with cryptogenic or radiation-induced OP, a 12-week regimen of clarithromycin and prednisone showed no benefit on remission rate and relapse rate as compared to a 24-week prednisone only regimen. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 230-238). Copyright:
Background: Some data suggest that anti-inflammatory macrolides may be effective to treat organizing pneumonia (OP) and prevent relapses, but no formal comparison with prednisone alone is available. To explore this issue, we retrospectively compared the efficacy of a 12-week combined regimen of clarithromycin and prednisone with a 24-week prednisone alone regimen in OP. Methods: A standard 12-week regimen of combined clarithromycin and prednisone was designed for the treatment of cryptogenic or radiation-induced OP, aiming at reducing the cumulated prednisone dose and the relapse rate. Its use was left to the discretion of the treating physicians, members of the Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires. Data were compared to a historical control group treated with a standard 24-week prednisone alone regimen. Results: 16 patients were treated with combined therapy and 21 with prednisone alone. Complete radiological remission was achieved in 63% of the combined therapy group and 81% of the prednisone alone group (p=0.38). Symptomatic relapses occurred in 81% of the combined therapy group, and 52% of the prednisone alone group (p=0.14). No side effect of clarithromycin was reported. Conclusions: In patients with cryptogenic or radiation-induced OP, a 12-week regimen of clarithromycin and prednisone showed no benefit on remission rate and relapse rate as compared to a 24-week prednisone only regimen. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 230-238). Copyright:
Authors: R Lazor; A Vandevenne; A Pelletier; P Leclerc; I Court-Fortune; J F Cordier Journal: Am J Respir Crit Care Med Date: 2000-08 Impact factor: 21.405