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Biotecnología Aplicada

On-line version ISSN 1027-2852

Abstract

CAYON, Isis et al. Gamma Interferon and prednisone decreasing-dose therapy in patients with Idiopathic Pulmonary Fibrosis. Biotecnol Apl [online]. 2010, vol.27, n.1, pp.29-35. ISSN 1027-2852.

Idiopathic pulmonary fibrosis (IPF) is a fatal disease to which no treatment has demonstrated to be a modifier of the disease pattern. The aim of this study was to obtain evidences of the efficacy and safety of a 6 month-course gamma interferon (IFNγ) treatment and prednisone decreasing-dose in patients with IPF. A pilot, open label, non-controlled clinical trial was carried out. Twelve patients with histophatologically-confirmed IPF were treated with 1 000 000 IU of recombinant human intramuscularl IFNγ, three times per week. Oral daily prednisone was concomitantly administered, once a day for a year, whose dose was gradually reduced from 60 to 20 mg. Clinical, functional, and imagenological evaluations were done before and at 3, 6 and 12 months after treatment. Most of the patients had clinical improvement; dyspnea, dry cough and crepitations were notably reduced. Forced vital capacity increased by over 12% in three patients while only one reduced such magnitude. Alterations in arterial gases were less frequent in the last evaluations. Fibrotic lesions were reduced in around half of the treated patients. Two of them died, but just one due to the disease. Considering withdrawals as failures, a 75% of patients was considered as responders (improvement + stable) at the end of IFNγ treatment (month 6), while 58.3% of response was obtained after follow-up (month 12). Treatment with IFNγ was well tolerated, since mild to moderate flu-like adverse reactions predominated. Two severe, unexpected events (deaths) occurred but no related to treatment. These results suggest that in IPF a rapid clinical response could be obtained with a therapeutic schedule with the well-tolerated IFNγ combined with prednisone decreasing-dose. Further, extensive controlled studies are encouraged.

Keywords : Idiopathic Pulmonary Fibrosis; Gamma interferon; prednisone; dyspnea.

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