Does interferon‐γ improve pulmonary function in idiopathic pulmonary fibrosis?

Abstract

Idiopathic pulmonary fibrosis (IPF) is a disease with progressive and devastating deterioration of lung function and a fatal prognosis, despite aggressive therapeutic attempts, which, in the majority of cases are futile.Recently, a preliminary study of long-term treatment with interferon (IFN)‐γ1band low-dose prednisolone in patients with IPF suggested that IFN‐γ1btreatment may improve lung function parameters of patients with IPF. Ever since, specialists in respiratory medicine who treat patients with IPF, are called by patients demanding treatment with IFN‐γ1b. Therefore, the authors here present another prospective investigation of IFN‐γ1bin five patients with IPF.According to the previously published design, patients received 200 µg IFN‐γ1bsubcutaneously three-times per week and 10 mg prednisolone orally for 12 months. Two patients stopped IFN‐γ1btreatment after 4 months due to side-effects and further lung function deterioration and one patient died 3 months after commencement of therapy. In total, pulmonary function improved in only one patient during IFN‐γ1btreatment, while four patients deteriorated.To conclude, this small series of idiopathic pulmonary fibrosis cases treated with interferon‐γ1band corticosteroids does not support previous data that this treatment improves pulmonary function or alters the natural course of idiopathic pulmonary fibrosis. Furthermore, in the authors' experience, side-effects of interferon‐γ1btreatment can significantly reduce patients' quality of life.

Long-term clinical effects of interferon gamma-1b and colchicine in idiopathic pulmonary fibrosis

“…KALRA et al [34] observed symptomatic and functional improvement in only one out of the 21 patients treated. Similarly, PRASSE et al [36] found improvement in physiological function in only one of five patients. In contrast, NATHAN et al [35] reported that, paradoxically, patients with advanced disease appear to derive the most benefit from IFN-c therapy.…”

“…Two small retrospective noncomparative [34,35] and one prospective noncomparative study [36] of IFN-c therapy for IPF have shown controversial results regarding the usefulness of IFN-c therapy. KALRA et al [34] observed symptomatic and functional improvement in only one out of the 21 patients treated.…”

High-Dose Acetylcysteine in Idiopathic Pulmonary Fibrosis

“…[6][7][8][9] On the basis of this hypothesis, there has been particular interest in antifibrotic drugs, 7 such as pirfenidone, 43,44 and in immune modulators, especially interferon gamma-1b. [45][46][47] In a recent double-blind study, pirfenidone was shown to improve vital capacity and to prevent acute exacerbations of idiopathic pulmonary fibrosis. 44 Interferon gamma-1b appeared to be effective in a pilot study, 45 but this was not confirmed in subsequent studies.…”

“…44 Interferon gamma-1b appeared to be effective in a pilot study, 45 but this was not confirmed in subsequent studies. 46,47 However, a retrospective analysis of the data of Raghu et al 46 found that a decrease of more than 10 percent in forced vital capacity (as a percentage * All diagnoses were based on the clinical judgment of the investigator and were blindly coded by qualified persons according to the Medical Dictionary for Regulatory Activities. 40 † Lower respiratory tract infections, pneumonia, bronchopneumonia, bronchitis, acute bronchitis, and bronchial infection are included.…”

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“…Nur 1 Patient zeigte eine Verbesserung in der Lungenfunktion, 4 Patienten verschlechterten sich, die Totalkapazität lag bei diesen Patienten im Mittel bei 57 %, während sie bei Ziesche u. Mitarb. 70 % betrug [6]. Französische Autoren berichteten, dass 4 Patienten im Endstadium der IPF (Totalkapazität unter 45 % oder CO-Diffusionskapazität unter 30 %) ein ARDSartiges Bild in engem Bezug zum Beginn der IFN-ã-1b-Therapie entwickelten und schlieûlich daran starben [7].…”