Efficacy of direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-DHP) in rapidly progressive interstitial pneumonias: results of a historical control study and a review of previous studies

Ichiyasu, Hidenori; Horio, Yuko; Masunaga, Aiko; Migiyama, Yohei; Sakamoto, Yasuhisa; Jodai, Takayuki; Ideguchi, Hideharu; Okabayashi, Hiroko; Hamada, Shohei; Yoshida, Chieko; Hirosako, Susumu; Okamoto, Shinichiro; Kohrogi, Hirotsugu

doi:10.1177/1753465817708950

Cited by 17 publications

(22 citation statements)

References 42 publications

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“…Itchyasu reported that among patients with AE-IPF, there was no difference in 3 month survival between PMX-DHP (40%) and control group (42.9%). However, when all types of IIP were included in the analysis, survival was better in the PMX-DHP group (Ichiyasu et al, 2017). Similarly, in the study by Furusawa et al, among the patients with AE-IPF, there was no difference in overall survival between the PMX-DHP (33%) and the control group (50%) (Furusawa et al, 2017).…”

Section: Sivelestatmentioning

confidence: 81%

“…The other two studies include various types of interstitial pneumonias. Furthermore, in addition to corticosteroids, other agents, such as CTX, CsA, tacrolimus, sivelestat or anticoagulants, were administered during the study period (Furusawa et al, 2017;Ichiyasu et al, 2017). Itchyasu reported that among patients with AE-IPF, there was no difference in 3 month survival between PMX-DHP (40%) and control group (42.9%).…”

Section: Sivelestatmentioning

confidence: 99%

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Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Kim

2022

Encyclopedia of Respiratory Medicine

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Section: Sivelestatmentioning

confidence: 81%

Section: Sivelestatmentioning

confidence: 99%

Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Kim

2022

Encyclopedia of Respiratory Medicine

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“…Although one study (Ikeda et al 34 ) also described the time at treatment since admission, it was not clearly reported. An additional report (Ichiyasu et al 31 ) described the time at PMX-DHP treatment since the diagnosis of the disease, which ranged from 0 to 48 days. Takada et al 29 mentioned a delay in instituting the PMX-DHP treatment after steroid pulse therapy, which was 0 in six patients and 2–6 days in seven patients (Table 3).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the efficacy of direct hemoperfusion with a polymyxin B–immobilized fibre column to treat rapidly progressive interstitial pneumonia

Kamiya

Panlaqui

2019

SAGE Open Medicine

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Objectives: Rapidly progressive interstitial pneumonia is a fatal disease with no established therapeutic options. The aim of this systematic review is to clarify the efficacy of interstitial pneumonia treatment utilizing direct hemoperfusion with a polymyxin B–immobilized fibre column. Methods: All patients with adult-onset rapidly progressive interstitial pneumonia including acute exacerbation of underlying chronic interstitial pneumonia were eligible. Primary studies of any design, which compared outcomes of direct hemoperfusion with a polymyxin B–immobilized fibre column treatment such as oxygenation and all-cause mortality with those of conventional therapy, were included. Electronic databases such as Medline and EMBASE were searched through October 7, 2018, and ICHUSHI, the largest database for medical articles in Japan, was also searched. Two reviewers independently extracted the relevant data and assessed the risk of bias in individual studies. The results were reported qualitatively due to substantial heterogeneity between studies. Results: Out of 775 records retrieved, 10 reports were eligible and 8 of them were included for further analysis. They were all retrospective studies including a total of 327 patients and contained some risk of bias. There was variation in the administration method of direct hemoperfusion with a polymyxin B–immobilized fibre column treatment such as the timing, frequency, duration and interval. Multivariate analyses of only two studies with historical controls demonstrated beneficial effects of direct hemoperfusion with a polymyxin B–immobilized fibre column treatment over conventional therapy with all-cause mortality hazard ratios of 0.345 (95% confidence interval: 0.127–0.936) and 0.505 (95% confidence interval: 0.270–0.904), respectively. A significant difference of an improvement in the ratio of partial arterial oxygen pressure to the fraction of inspired oxygen in-between two treatment groups was also reported in two studies utilizing historical controls with mean differences of 56.8 and 57.5 mmHg, respectively. Conclusions: There is currently insufficient data to support the use of direct hemoperfusion with a polymyxin B–immobilized fibre column treatment for rapidly progressive interstitial pneumonia. It should be instituted for research purposes only until new evidence is available.

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“…Direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-DHP) is a blood purification therapy used to treat septic shock, 4 and acute respiratory diseases such as rapidly progressing interstitial pneumonia 5 and acute exacerbation of idiopathic pulmonary fibrosis. 6 COVID-19 pneumonia can also take the form of interstitial changes, 7 but few reports are available on the use of PMX-DHP therapy in patients with COVID-19 pneumonia.…”

Section: Introductionmentioning

confidence: 99%

PMX-DHP Therapy for Dyspnea and Deoxygenation in Severe COVID-19 Pneumonia: A Case Series

Kuwana¹,

Kinoshita²,

Hirabayashi³

et al. 2021

IDR

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Hypercytokinemia induced by coronavirus disease-19 (COVID-19) is associated with severe pulmonary involvement, which may lead to respiratory failure. These conditions play an important role in the worsening of clinical symptoms in patients with severe COVID-19. There is no established treatment for hypercytokinemia. We report on two patients whose clinical symptoms improved after direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-DHP), following the administration of the anti-inflammatory agent tocilizumab. Case A was a 70-year-old man diagnosed with COVID-19 pneumonia. Despite treatment with ciclesonide and favipiravir, supplemental oxygen was administered due to the worsening of dyspnea with tachypnea. Although tocilizumab was started on day 6, the patient deteriorated into deoxygenation, presenting with the PaO 2 /F I O 2 (P/F) ratio of 92. On days 8 and 10, the patient received PMX-DHP therapy. On day 11, his dyspnea improved. On day 13, his P/F ratio began to improve, and oxygen therapy was discontinued on day 18. The patient recovered without requiring mechanical ventilation. Case B was a 70-year-old man diagnosed with COVID-19 pneumonia and treated with favipiravir, starting on day 0. Despite starting ciclesonide inhalation and tocilizumab on day 2, his P/F ratio was 53. On day 5, he received PMX-DHP therapy. On day 6, his dyspnea improved, as did his P/F ratio, reaching 81 on day 8. Finally, his clinical symptoms resolved, and he was discharged from the intensive care unit without requiring mechanical ventilation. These cases indicate that PMX-DHP therapy might be a suitable treatment option for dyspnea and deoxygenation in COVID-19 pneumonia, especially in cases where an anti-inflammatory agent, such as tocilizumab, has failed to achieve the desired effect.

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Efficacy of direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-DHP) in rapidly progressive interstitial pneumonias: results of a historical control study and a review of previous studies

Cited by 17 publications

References 42 publications

Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Acute Exacerbation of Idiopathic Pulmonary Fibrosis

A systematic review of the efficacy of direct hemoperfusion with a polymyxin B–immobilized fibre column to treat rapidly progressive interstitial pneumonia

PMX-DHP Therapy for Dyspnea and Deoxygenation in Severe COVID-19 Pneumonia: A Case Series

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