Colchicine Versus Prednisone as Treatment of Usual Interstitial Pneumonia
Section snippets
PATIENTS AND METHODS
Inclusion Criteria.—Medical records were reviewed to identify patients treated with colchicine or prednisone as initial single-drug therapy for UIP. Patients were included in the study only if they had progressive dyspnea, bibasilar inspiratory crackles, typical chest roentgenograms, PFT results consistent with VIP, either HRCT that showed findings characteristic of UIP or OLB specimens that revealed VIP, and at least one follow-up PFT within 2 years after diagnosis. A “very high probability of
RESULTS
Baseline characteristics of the 22 colchicine-treated patients and 22 prednisone-treated patients are summarized in Table 1. UIP was diagnosed more recently in the colchicine-treated patients (1983 to 1995) than in the prednisonetreated patients (1975 to 1985). A higher percentage of prednisone-treated than colchicine-treated patients underwent OLB (100% versus 23%; P <0.001), and a lower percentage of the prednisone group than of the colchicine group had HRCT (0% versus 95%; P<0.001). Age,
DISCUSSION
In the current study, we found no statistically significant difference in the rate of decline of pulmonary function between patients treated with colchicine and patients receiving prednisone as a single initial agent. A trend for a more rapid decline of pulmonary function and for a greater proportion of patients experiencing a significant (as defined by ATS criteria) decline of pulmonary function during the first 2 years in the prednisone-treated than in the colchicine-treated group was
CONCLUSION
This study lends further support to the assumption that colchicine may be a satisfactory substitute for high-dose prednisone in the initial treatment of patients with UIP. This study does not resolve whether results with either colchicine or prednisone differ from results with use of no therapy. Randomized prospective studies of colchicine in the treatment of UIP should be conducted to confirm these preliminary results.
ACKNOWLEDGMENT
We acknowledge, with gratitude, the assistance of Kenneth C. Beck, Ph.D., for retrieving pulmonary function data; Andrew H. Limper, M.D., Ulrich Specks, M.D., and Kenneth P. Offord, M.S., for offering helpful suggestions for this study; our colleagues at Mayo Clinic Rochester, Mayo Clinic Jacksonville, and Mayo Clinic Scottsdale for identifying patients for the colchicine registry; and Gail M. Caron for maintaining the colchicine registry.
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