A 12-WEEK COMBINATION OF CLARITHROMYCIN AND PREDNISONE COMPARED TO A 24-WEEK PREDNISONE ALONE TREATMENT IN CRYPTOGENIC AND RADIATION-INDUCED ORGANIZING PNEUMONIA

Nicolas Petitpierre 1 Vincent Cottin 2 Sylvain Marchand-Adam 3 Sandrine Hirschi 4 Dominique Rigaud Isabelle Court-Fortune 5 Stéphane Jouneau 6, 7 Dominique Israel-Biet 8 Anita Molard 4 Jean-Francois Cordier 9 Romain Lazor 9, 1
1 CHUV - Centre Hospitalier Universitaire Vaudois [Lausanne]
2 Centre de Référence des Maladies Pulmonaires Rares - Service de Pneumologie [Hôpital Louis Pradel – CHU Lyon]
3 CHRU TOURS - Centre Hospitalier Régional Universitaire de Tours
4 CHU Strasbourg
5 CHU de Saint-Etienne - Centre Hospitalier Universitaire de Saint-Etienne
6 Irset - Institut de recherche, santé, environnement et travail
7 CHU Pontchaillou [Rennes]
8 HEGP - Hôpital Européen Georges Pompidou [APHP]
9 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
Abstract : Background Some data suggest that anti-inflammatory macrolides may be effective to treat organizing pneumonia (OP) and prevent relapses, but no formal comparison with prednisone alone is available. To explore this issue, we retrospectively compared the efficacy of a 12-week combined regimen of clarithromycin and prednisone with a 24-week prednisone alone regimen in OP. Methods A standard 12-week regimen of combined clarithromycin and prednisone was designed for the treatment of cryptogenic or radiation-induced OP, aiming at reducing the cumulated prednisone dose and the relapse rate. Its use was left to the discretion of the treating physicians, members of the Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires. Data were compared to a historical control group treated with a standard 24-week prednisone alone regimen. Results 16 patients were treated with combined therapy and 21 with prednisone alone. Complete radiological remission was achieved in 63% of the combined therapy group and 81% of the prednisone alone group (p=0.38). Symptomatic relapses occurred in 81% of the combined therapy group, and 52% of the prednisone alone group (p=0.14). No side effect of clarithromycin was reported. Conclusions In patients with cryptogenic or radiation-induced OP, a 12-week regimen of clarithromycin and prednisone showed no benefit on remission rate and relapse rate as compared to a 24-week prednisone only regimen.
Keywords : recurrence clarithromycin treatment outcome glucocorticoids cryptogenic organizing pneumonia lung diseases interstitial
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Journal articles
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01973780
Contributor : Laurent Jonchère <>
Submitted on : Tuesday, January 8, 2019 - 2:45:48 PM
Last modification on : Thursday, July 11, 2019 - 1:00:34 AM

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Nicolas Petitpierre, Vincent Cottin, Sylvain Marchand-Adam, Sandrine Hirschi, Dominique Rigaud, et al.. A 12-WEEK COMBINATION OF CLARITHROMYCIN AND PREDNISONE COMPARED TO A 24-WEEK PREDNISONE ALONE TREATMENT IN CRYPTOGENIC AND RADIATION-INDUCED ORGANIZING PNEUMONIA. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders, 2018, 35 (3), pp.230-238. ⟨hal-01973780⟩

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