Nakashima Kazuki, Yanagihara Toyoshi, Ishida Sae, Ogo Naruhiko, Egashira Ayaka, Asoh Tatsuma, Maeyama Takashige
Department of Respiratory Medicine, Hamanomachi Hospital, Fukuoka, 810-8539, Japan.
Department of Pharmacy, Hamanomachi Hospital, Fukuoka, 810-8539, Japan.
Respir Med Case Rep. 2021 Mar 9;33:101385. doi: 10.1016/j.rmcr.2021.101385. eCollection 2021.
We describe three cases of acute exacerbation of interstitial lung diseases (ILDs) in which patients were treated with pulsed-doses of corticosteroids followed by nintedanib and maintenance doses of corticosteroids. All cases responded well to pulsed-dose corticosteroids. However, in conventional practice, corticosteroids can complicate adverse events, including opportunistic infections, diabetes, and osteoporosis. One of the cases reported here involved dermatomyositis-associated ILD with anti-EJ antibodies. Considering possible side effects of corticosteroids and the frequent recurrence of ILDs associated with anti-EJ antibodies, we decided to use nintedanib as a sequential treatment for acute exacerbation of ILDs. Nintedanib has just been approved for treatment of progressive fibrosing ILD, but to date, few reports of acute exacerbation of ILDs treated with nintedanib have been published. This case series may contribute to a more thorough discussion regarding the use and timing of nintedanib in treating acute exacerbation of ILDs.
我们描述了3例间质性肺疾病（ILD）急性加重的病例，这些患者先接受了脉冲剂量的皮质类固醇治疗，随后使用了尼达尼布，并维持皮质类固醇剂量。所有病例对脉冲剂量的皮质类固醇均反应良好。然而，在传统治疗中，皮质类固醇会使不良事件复杂化，包括机会性感染、糖尿病和骨质疏松症。此处报告的其中1例病例为抗EJ抗体相关的皮肌炎相关性ILD。考虑到皮质类固醇可能的副作用以及与抗EJ抗体相关的ILD频繁复发，我们决定使用尼达尼布作为ILD急性加重的序贯治疗药物。尼达尼布刚刚被批准用于治疗进行性纤维化ILD，但迄今为止，关于使用尼达尼布治疗ILD急性加重的报道很少。该病例系列可能有助于更全面地讨论尼达尼布在治疗ILD急性加重中的使用和时机。
