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The following is a summary of “Effectiveness and pharmacoeconomic study of using different corticosteroids in the treatment of hypersensitivity pneumonitis,” published in the February 2024 issue of Pulmonology by Elhennawy et al.

Interstitial lung diseases (ILDs) encompass a spectrum of conditions characterized by inflammation and fibrosis of the alveolar walls, leading to impaired gas exchange. Hypersensitivity pneumonitis (HP) is the third most prevalent subtype within ILDs. The cornerstone of treatment for HP remains corticosteroids. Notably, using intramuscular (IM) betamethasone or intravenous (IV) dexamethasone in weekly pulse doses has demonstrated superior efficacy to daily oral prednisolone in HP patients. This study aims to comprehensively compare various corticosteroids in terms of their clinical effectiveness and economic considerations.

To evaluate treatment effectiveness, 107 patients underwent pulmonary function tests (PFTs) and assessment of inflammatory markers. A cost-effectiveness analysis (CEA) was conducted, calculating incremental cost-effectiveness ratios (ICERs) among three distinct treatment groups.

Following treatment, the betamethasone group exhibited a significant reduction in Krebs von den Lungen-6 (KL-6) levels from 723.22 ± 218.18 U/ml to 554.48 ± 129.69 U/ml (p = 0.001). Likewise, the dexamethasone group notably improved the erythrocyte sedimentation rate (ESR) from 56.12 ± 27.97 mm to 30.06 ± 16.04 mm (p = 0.048). All three treatment groups exhibited significant enhancements in forced expiratory volume (FEV₁), forced vital capacity (FVC), and six-minute walk distance (6MWD). Moreover, oxygen desaturation percentage (SpO₂) improvements were observed within the dexamethasone and betamethasone groups. From an economic standpoint, betamethasone and dexamethasone emerged as more cost-effective options than prednisolone, as evidenced by their ICERs positioning within quadrant C. Furthermore, a comparison between betamethasone and dexamethasone revealed a marginal cost difference, with betamethasone demonstrating superior benefits.

Betamethasone and dexamethasone emerge as superior alternatives to prednisolone in ameliorating HP’s inflammatory response and clinical manifestations. Furthermore, betamethasone emerges as the optimal intervention concerning cost-effectiveness, underscoring its potential as a preferred treatment modality in managing HP.

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02896-z