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进展性肺纤维化与特发性肺纤维化的抗纤维化治疗反应比较。

Antifibrotic treatment response comparison of progressive pulmonary fibrosis and idiopathic pulmonary fibrosis.

机构信息

Department of Chest Disease, Atatürk Sanatorium Research and Training Hospital, University of Health Sciences, Ankara, Turkiye.

出版信息

Turk J Med Sci. 2024 May 27;54(5):900-907. doi: 10.55730/1300-0144.5866. eCollection 2024.

Abstract

BACKGROUND/AIM: Idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) are two entities categorized as fibrotic lung diseases. With a similar clinical presentation and treatment modalities in many cases, the line differentiating these two diseases may not be evident. Hence, it was aimed herein to evaluate the effectiveness of antifibrotic treatment and the course of fibrotic lung diseases.

MATERIALS AND METHODS

The study included patients diagnosed with IPF and PPF who were given antifibrotic treatment and followed-up for 12 months at our clinic. At the final follow-up, treatment response and radiological evaluation were investigated via high-resolution computed tomography.

RESULTS

Eighty-seven patients were included in the study (57 with IPF and 30 with PPF). Under antifibrotic treatment, there were no statistically significant decreases in the six-minute walking test, forced vital capacity, and diffusing capacity of the lungs for carbon monoxide values at 6 and 12 months posttreatment. The most common side effects were photosensitivity for patients under the pirfenidone regimen, while diarrhea was predominantly observed in the PPF group. Radiological progression was observed in 22.9% of the patients at 12 months posttreatment. Hospitalization requirements were more evident in the PPF group, with at least one hospitalization history present in 60% (n = 18) of the PPF patients compared to 12.3% (n = 7) of the IPF patients.

CONCLUSION

A personalized approach is preferred with similar clinical profiles for both treatment modalities, with specific side effects considered.

摘要

背景/目的:特发性肺纤维化 (IPF) 和进行性肺纤维化 (PPF) 是两种被归类为肺纤维化疾病的实体。在许多情况下,它们具有相似的临床表现和治疗方式,因此区分这两种疾病的界限可能并不明显。因此,本研究旨在评估抗纤维化治疗的效果以及纤维化性肺疾病的病程。

材料和方法

该研究纳入了在我院接受抗纤维化治疗并随访 12 个月的 IPF 和 PPF 患者。在最终随访时,通过高分辨率计算机断层扫描评估治疗反应和影像学评估。

结果

本研究纳入了 87 例患者(57 例 IPF,30 例 PPF)。在接受抗纤维化治疗后,6 个月和 12 个月时,六分钟步行试验、用力肺活量和一氧化碳弥散量均无统计学意义的下降。最常见的副作用是吡非尼酮组的光敏性,而腹泻主要发生在 PPF 组。治疗后 12 个月时,有 22.9%的患者出现影像学进展。PPF 组的住院需求更为明显,60%(n=18)的 PPF 患者至少有一次住院史,而 IPF 患者仅为 12.3%(n=7)。

结论

对于两种治疗方式具有相似临床特征的患者,建议采用个体化方法,并考虑特定的副作用。

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本文引用的文献

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2022 update on clinical practice guidelines for idiopathic pulmonary fibrosis and progressive pulmonary fibrosis.
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Progressive fibrosing interstitial lung disease: a clinical cohort (the PROGRESS study).
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