Efficacy of short-term prednisolone treatment in patients with chronic eosinophilic pneumonia

Abstract

In patients with chronic eosinophilic pneumonia (CEP), dramatic improvements are seen in response to corticosteroid therapy; however, relapse is common after treatment has ceased. The optimal duration of corticosteroid therapy remains unclear.In a randomised, open-label, parallel group study, eligible patients with CEP received oral prednisolone for either 3 months (3-month group) or 6 months (6-month group), followed by 2 years observation. All patients were treated with an initial dose of prednisolone of 0.5 mg·kg −1 ·day −1, which was then tapered and discontinued at either 3 or 6 months. The primary end-point was relapse during the follow-up period.In the final analysis, there were 23 patients in the 3-month group and 21 patients in the 6-month group. All patients showed a good response to prednisolone treatment. There were 12 (52.1%) relapses in the 3-month group and 13 (61.9%) relapses in the 6-month group. No significant difference was found in the cumulative rate of relapse ( p=0.56). All relapse cases showed improvement upon resumption of prednisolone treatment.No difference was observed in the rate of relapse between the 3-and 6-month prednisolone treatment groups for patients with CEP. @ERSpublications Short-term, 3 month, prednisolone treatment is a therapeutic option for chronic eosinophilic pneumonia

The Long-term Clinical Course of Chronic Eosinophilic Pneumonia

“…These differences may be due to physique (body weight), which is often lower in Asian people, but the exact body weight on relapse in many of our patients was unknown. CEP relapse occurred after PSL cessation at a median duration of 56 days, which was shorter than that reported by Marchand et al (3) or Oyama et al (7), but the exact reason remains unclear.…”

“…In addition, to our knowledge, only one report has assessed the predictive factors of CEP relapse, and to date, it is not known which factors are predictive of relapse of CEP (7). Thus, the aim of the present study was to investigate the frequency at which patients with CEP developed DM or infections, focusing especially on pulmonary nontuberculous mycobacteriosis (pNTM), of which corticosteroid therapy is a risk factor (8), and to assess factors predictive of the relapse of CEP.…”

Chronic Eosinophilic Pneumonia: Adjunctive Therapy With Inhaled Steroids

“…Relapsed ICEP tends to remain responsive to oral corticosteroids [2,3,5,8,15]. Recently one study evaluated the rate and risk of relapse in patients undergoing shorter courses of oral steroid tapers [15]. They found no significant difference in the either the rate or risk of relapse at three months compared to six.…”

“…Relapses have been observed in 37e58% of patients with ICEP [2,3,8,14]. Relapsed ICEP tends to remain responsive to oral corticosteroids [2,3,5,8,15]. Recently one study evaluated the rate and risk of relapse in patients undergoing shorter courses of oral steroid tapers [15].…”

“…To date, there have not been readily identified risk factors that predict risk of relapse, including serologic testing [5,8,9,15]. One potential negative predictor for the risk of relapse is the use of ICS in ICEP with asthma despite the lack of efficacy of ICS as monotherapy [6,11].…”