The efficacy of tacrolimus in patients with interstitial lung diseases complicated with polymyositis or dermatomyositis

Takashi Kurita, Shinsuke Yasuda, Koji Oba, Toshio Odani, Michihito Kono, Kotaro Otomo, Yuichiro Fujieda, Kenji Oku, Toshiyuki Bohgaki, Olga Amengual, Tetsuya Horita, Tatsuya Atsumi

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objective. Interstitial lung diseases (ILDs) complicated with PM or DM are frequently aggressive and refractory to treatment. Recently some reports have suggested the potential benefit of tacrolimus for severe ILD complicated with PM/DM. However, little evidence has yet shown the efficacy of tacrolimus in these settings. The aim of this study was to evaluate the efficacy of tacrolimus as a treatment for PM-/DM-related ILD.Methods. This retrospective study comprised 49 previously untreated patients diagnosed as PM-/DM-related ILD admitted to Hokkaido University Hospital from January 2000 to July 2013. These patients were treated with tacrolimus plus conventional therapy or only with conventional therapy (prednisolone, i.v. CYC and/or ciclosporin). The primary endpoint was defined as the time to relapse or death of respiratory cause or a serious adverse event. The secondary endpoint was defined as the time from the initiation of immunosuppressive treatment to relapse or death of respiratory cause. Endpoints were compared by adjusted Cox regression model by using inverse probability of treatment weighting in order to reduce the impact of these selection biases and potential confounding factors.Results. After adjustment, the tacrolimus group (n = 25) had significantly longer event-free survival as compared with the conventional therapy group (n = 24). The weighted hazard ratio (HR) was 0.32 (95% CI 0.14, 0.75, P = 0.008). In addition, the tacrolimus group had significantly longer disease-free survival as compared with the conventional therapy group. The weighted HR was 0.25 (95% CI 0.10, 0.66, P = 0.005).Conclusion. The addition of tacrolimus to conventional therapy significantly improved the prognosis of patients with PM-/DM-related ILD.

Original languageEnglish
Article numberkeu166
Pages (from-to)39-44
Number of pages6
JournalRheumatology (United Kingdom)
Volume54
Issue number1
DOIs
Publication statusPublished - 2014 Nov 24
Externally publishedYes

Fingerprint

Dermatomyositis
Interstitial Lung Diseases
Tacrolimus
Group Psychotherapy
Therapeutics
Disease-Free Survival
Cause of Death
Social Adjustment
Recurrence
Selection Bias
Immunosuppressive Agents
Prednisolone
Proportional Hazards Models
Cyclosporine
Retrospective Studies

Keywords

  • Dermatomyositis
  • Interstitial
  • Lung diseases
  • Polymyositis
  • Tacrolimus

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

The efficacy of tacrolimus in patients with interstitial lung diseases complicated with polymyositis or dermatomyositis. / Kurita, Takashi; Yasuda, Shinsuke; Oba, Koji; Odani, Toshio; Kono, Michihito; Otomo, Kotaro; Fujieda, Yuichiro; Oku, Kenji; Bohgaki, Toshiyuki; Amengual, Olga; Horita, Tetsuya; Atsumi, Tatsuya.

In: Rheumatology (United Kingdom), Vol. 54, No. 1, keu166, 24.11.2014, p. 39-44.

Research output: Contribution to journalArticle

Kurita, T, Yasuda, S, Oba, K, Odani, T, Kono, M, Otomo, K, Fujieda, Y, Oku, K, Bohgaki, T, Amengual, O, Horita, T & Atsumi, T 2014, 'The efficacy of tacrolimus in patients with interstitial lung diseases complicated with polymyositis or dermatomyositis', Rheumatology (United Kingdom), vol. 54, no. 1, keu166, pp. 39-44. https://doi.org/10.1093/rheumatology/keu166
Kurita, Takashi ; Yasuda, Shinsuke ; Oba, Koji ; Odani, Toshio ; Kono, Michihito ; Otomo, Kotaro ; Fujieda, Yuichiro ; Oku, Kenji ; Bohgaki, Toshiyuki ; Amengual, Olga ; Horita, Tetsuya ; Atsumi, Tatsuya. / The efficacy of tacrolimus in patients with interstitial lung diseases complicated with polymyositis or dermatomyositis. In: Rheumatology (United Kingdom). 2014 ; Vol. 54, No. 1. pp. 39-44.
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abstract = "Objective. Interstitial lung diseases (ILDs) complicated with PM or DM are frequently aggressive and refractory to treatment. Recently some reports have suggested the potential benefit of tacrolimus for severe ILD complicated with PM/DM. However, little evidence has yet shown the efficacy of tacrolimus in these settings. The aim of this study was to evaluate the efficacy of tacrolimus as a treatment for PM-/DM-related ILD.Methods. This retrospective study comprised 49 previously untreated patients diagnosed as PM-/DM-related ILD admitted to Hokkaido University Hospital from January 2000 to July 2013. These patients were treated with tacrolimus plus conventional therapy or only with conventional therapy (prednisolone, i.v. CYC and/or ciclosporin). The primary endpoint was defined as the time to relapse or death of respiratory cause or a serious adverse event. The secondary endpoint was defined as the time from the initiation of immunosuppressive treatment to relapse or death of respiratory cause. Endpoints were compared by adjusted Cox regression model by using inverse probability of treatment weighting in order to reduce the impact of these selection biases and potential confounding factors.Results. After adjustment, the tacrolimus group (n = 25) had significantly longer event-free survival as compared with the conventional therapy group (n = 24). The weighted hazard ratio (HR) was 0.32 (95{\%} CI 0.14, 0.75, P = 0.008). In addition, the tacrolimus group had significantly longer disease-free survival as compared with the conventional therapy group. The weighted HR was 0.25 (95{\%} CI 0.10, 0.66, P = 0.005).Conclusion. The addition of tacrolimus to conventional therapy significantly improved the prognosis of patients with PM-/DM-related ILD.",
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AU - Kurita, Takashi

AU - Yasuda, Shinsuke

AU - Oba, Koji

AU - Odani, Toshio

AU - Kono, Michihito

AU - Otomo, Kotaro

AU - Fujieda, Yuichiro

AU - Oku, Kenji

AU - Bohgaki, Toshiyuki

AU - Amengual, Olga

AU - Horita, Tetsuya

AU - Atsumi, Tatsuya

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N2 - Objective. Interstitial lung diseases (ILDs) complicated with PM or DM are frequently aggressive and refractory to treatment. Recently some reports have suggested the potential benefit of tacrolimus for severe ILD complicated with PM/DM. However, little evidence has yet shown the efficacy of tacrolimus in these settings. The aim of this study was to evaluate the efficacy of tacrolimus as a treatment for PM-/DM-related ILD.Methods. This retrospective study comprised 49 previously untreated patients diagnosed as PM-/DM-related ILD admitted to Hokkaido University Hospital from January 2000 to July 2013. These patients were treated with tacrolimus plus conventional therapy or only with conventional therapy (prednisolone, i.v. CYC and/or ciclosporin). The primary endpoint was defined as the time to relapse or death of respiratory cause or a serious adverse event. The secondary endpoint was defined as the time from the initiation of immunosuppressive treatment to relapse or death of respiratory cause. Endpoints were compared by adjusted Cox regression model by using inverse probability of treatment weighting in order to reduce the impact of these selection biases and potential confounding factors.Results. After adjustment, the tacrolimus group (n = 25) had significantly longer event-free survival as compared with the conventional therapy group (n = 24). The weighted hazard ratio (HR) was 0.32 (95% CI 0.14, 0.75, P = 0.008). In addition, the tacrolimus group had significantly longer disease-free survival as compared with the conventional therapy group. The weighted HR was 0.25 (95% CI 0.10, 0.66, P = 0.005).Conclusion. The addition of tacrolimus to conventional therapy significantly improved the prognosis of patients with PM-/DM-related ILD.

AB - Objective. Interstitial lung diseases (ILDs) complicated with PM or DM are frequently aggressive and refractory to treatment. Recently some reports have suggested the potential benefit of tacrolimus for severe ILD complicated with PM/DM. However, little evidence has yet shown the efficacy of tacrolimus in these settings. The aim of this study was to evaluate the efficacy of tacrolimus as a treatment for PM-/DM-related ILD.Methods. This retrospective study comprised 49 previously untreated patients diagnosed as PM-/DM-related ILD admitted to Hokkaido University Hospital from January 2000 to July 2013. These patients were treated with tacrolimus plus conventional therapy or only with conventional therapy (prednisolone, i.v. CYC and/or ciclosporin). The primary endpoint was defined as the time to relapse or death of respiratory cause or a serious adverse event. The secondary endpoint was defined as the time from the initiation of immunosuppressive treatment to relapse or death of respiratory cause. Endpoints were compared by adjusted Cox regression model by using inverse probability of treatment weighting in order to reduce the impact of these selection biases and potential confounding factors.Results. After adjustment, the tacrolimus group (n = 25) had significantly longer event-free survival as compared with the conventional therapy group (n = 24). The weighted hazard ratio (HR) was 0.32 (95% CI 0.14, 0.75, P = 0.008). In addition, the tacrolimus group had significantly longer disease-free survival as compared with the conventional therapy group. The weighted HR was 0.25 (95% CI 0.10, 0.66, P = 0.005).Conclusion. The addition of tacrolimus to conventional therapy significantly improved the prognosis of patients with PM-/DM-related ILD.

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