Colchicine, D-Penicillamine, and Prednisone in the Treatment of Idiopathic Pulmonary Fibrosis: Results
In addition, when initial and 2-year follow-up lung function tests were examined only in survivors, significant differences were not found (not shown). Thirteen of the 56 patients included in the study died during the first 2 years, and 29 were dead at 5 years of follow-up. The survival curves of the four groups are presented in Figure 1. Comparison of survival in the four treatment groups by Cox regression model showed no statistically significant difference among them.
Women displayed higher mortality than men. Thus, at the 5-year follow-up, 23 of 36 female vs 6 of 20 male had died (p<0.02). Age was not a prognostic factor for these patients, and both young and older patients’ conditions worsened, and some even died without significant differences.
Evolution time before diagnosis was 38 ±34 months in group 1, 16 ±13 months in group 2, 35 ±25 months in group 3, and 14 ±13 months in group 4 (p=0.09). No significant association between evolution time before diagnosis and survival was found.
Using a semiquantitative histologic approach, the percentage of fibrosis in the lung samples varied from 10 to 70%, and there was no statistical difference among the four groups. However, independently of treatment scheme, survivors showed a significantly lower percentage of lung fibrosis in comparison to patients who died (37±17 vs 54 ±16; p=0.002) review canadian family pharmacy.
Adverse effects attributed to prednisone were observed in 90% of the patients and included increased appetite and weight gain (90%), gastritis and/or peptic ulcer disease (28%), hyperglycemia (9%), depression (5%), osteoporosis (5%), and muscular weakness (3%). No side effects other than mild diarrhea (10% of the patients) were noted in patients who used colchicine. Probably due to the low doses used, no side effects attributable to D-penicillamine were observed. In general, patients complained more of the known adverse effects of prednisone than those observed with the other drugs.
Figure 1. Kaplan-Meier estimate of survival in a cohort of 156 IPF patients separated by treatment. There were no significant differences between subgroups.