Low dosage of corticosteroid may improve prognosis of idiopathic pulmonary fibrosis: BMC

A new study conducted by Keisuke Anan and team showed that in individuals with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF), early corticosteroid dosage lowering was linked to a good prognosis. The findings of this study were published in BMC Respiratory Research.

The most prevalent form of idiopathic interstitial pneumonia (IP), idiopathic pulmonary fibrosis (IPF), is characterized by persistent, progressive lung fibrosis. There is little agreement on the tapering protocol, despite  the fact that corticosteroid therapy with dosage reduction is the most often used treatment for acute exacerbation of idiopathic pulmonary fibrosis. The purpose of this study was to determine if early corticosteroid dosage tapering and in-hospital mortality in patients with AE-IPF are related.

In this retrospective cohort study, researchers examined administrative data from a cohort of 185 Japanese hospitals and a cohort of eight Japanese tertiary care institutions. Depending on whether the maintenance dose of corticosteroids was lowered within two weeks of admission, patients with AE-IPF were divided into early and non-early tapering groups. To calculate the impact of early corticosteroid dosage tapering, Propensity Score Analysis with Inverse Probability Weighting (IPW) was used.

The key findings of this study were:

1. In contrast to the administrative cohort, which consisted of 229 individuals, 47 (31%) of the 153 eligible patients in the multi-center group perished.

2. Patients who began tapering sooner than later typically had a better prognosis.

3. The early tapering group showed a more favorable outlook following IPW than the non-early tapering group.

In conclusion, in patients with AE-IPF, early reduction of the corticosteroid dosage was linked to a decreased risk of in-hospital death. The findings of this study imply that doctors should think about early corticosteroid dosage reduction in patients with AE-IPF. It is necessary to conduct further randomized controlled studies to examine the impact of early tapering of corticosteroid dosage on outcomes in AE-IPF patients.

Reference:

Anan, K., Kataoka, Y., Ichikado, K., Kawamura, K., Johkoh, T., Fujimoto, K., Tobino, K., Tachikawa, R., Ito, H., Nakamura, T., Kishaba, T., Inomata, M., Ogawa, Y., & Yamamoto, Y. (2022). Early corticosteroid dose tapering in patients with acute exacerbation of idiopathic pulmonary fibrosis. In Respiratory Research (Vol. 23, Issue 1). Springer Science and Business Media LLC.https://doi.org/10.1186/s12931-022-02195-3