Comparison of therapeutic effects of combination therapy with prednisolone and tacrolimus or azathioprine on progressive interstitial pneumonia with systemic sclerosis

Abstract

Objectives We retrospectively compared the therapeutic effects of combination therapy with prednisolone (PSL) and oral tacrolimus (TAC) or azathioprine (AZA) on progressive interstitial pneumonia with systemic sclerosis (SSc-PIP). Methods The effects of PSL (0.2–0.5 mg/kg/day) and TAC (3 mg/day) or AZA (1–2 mg/kg/day) therapies (n = 18) were evaluated for short (12 months) and long (36 months or more) periods. Results In the short period, IP improved in 6 and 5 patients and was stable in 12 and 13 patients in the TAC and AZA groups, respectively. In the long period, 11 patients were followed up in the TAC group and 12 in the AZA group. IP improved in 4 and 2 patients and was stable in seven and nine in the TAC and AZA groups, respectively. The rates of evolution of total fibrosis score, and those corrected by disease duration for the long period, in the TAC group were significantly lower than those in the AZA group (p = .017 and .025, respectively). Conclusion The inhibitory effect of PSL and TAC combination therapy on the progression of fibrosis in SSc-PIP may be superior to that of PSL and AZA in the long period.

Pachymic acid inhibits inflammation and cell apoptosis in lipopolysaccharide (LPS)-induced rat model with pneumonia by regulating NF-κB and MAPK pathways

“…2 A better understanding of the underlying mechanism of childhood pneumonia could contribute to the development of an effective and novel treatment to overcome this burden. 3,4 Fighting infection is the primary need toward treating pneumonia. Since pneumonia is a disease caused by a variety of pathogenic microorganisms infecting the lung parenchyma, anti-infective drugs are the first choice for its treatment.…”

Tacrolimus and the Treatment of Pulmonary Fibrosis

“…SSc-associated ILD and PAH are severe complications with poor prognoses. A clinical study indicated that TAC effectively reduces ILD progression and improves lung function in patients with SSc ( 6 ). This study presents innovative therapeutic strategies for patients with SSc complicated by ILD and PAH, highlighting the potential benefits of TAC not only in inhibiting fibrosis but also in potentially ameliorating PAH through the upregulation of BMPR2.…”

Reply to: Huang et al.

“…As highlighted by Huang and colleagues, the downregulation of the BMPR2 signaling pathway is pivotal in the development of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) ( 2 ). The evidence suggesting that tacrolimus can improve fibrosis progression and lung function in patients with SSc further underscores its therapeutic potential ( 3 ). Notably, tacrolimus can restore BMPR2 signaling across a spectrum, from lower concentrations (0.2–2 ng/ml) to elevated levels (>5 ng/ml, within the immunosuppressive range) ( 4 ).…”