Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan.
Mod Rheumatol. 2022 Feb 28;32(2):358-364. doi: 10.1080/14397595.2021.1918864.
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).
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.
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).
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.
我们回顾性比较了泼尼松龙（PSL）联合他克莫司（TAC）或硫唑嘌呤（AZA）治疗系统性硬化症相关性间质性肺炎（SSc-PIP）进展期的疗效。
评估了 PSL（0.2-0.5mg/kg/日）联合 TAC（3mg/日）或 AZA（1-2mg/kg/日）治疗（n=18）的短期（12 个月）和长期（36 个月或更长时间）疗效。
在短期治疗中，TAC 组的 6 例和 5 例患者的间质性肺炎改善，12 例和 13 例患者的间质性肺炎稳定；AZA 组的 11 例患者完成了长期随访，12 例患者完成了长期随访。TAC 组的 4 例和 2 例患者的间质性肺炎改善，7 例和 9 例患者的间质性肺炎稳定；TAC 组的总纤维化评分的进展率及经疾病持续时间校正的进展率均显著低于 AZA 组（p=0.017 和 0.025）。
PSL 联合 TAC 治疗可能在长期抑制 SSc-PIP 纤维化进展方面优于 PSL 联合 AZA。
