For a study, it was determined that researchers knew very little about the characteristics of patients with interstitial pneumonia with autoimmune features (IPAF) that were linked to the immunosuppressive response. They used existing IPAF criteria for an investigation to define variables associated with treatment response. They performed a single-center medical records review on 63 patients with IPAF to look for serological, clinical, and morphological factors linked with an immunosuppressive response. The response was defined as a 10% drop in relative functional vital capacity and the absence of mortality or lung transplant within the first year of continuous immunosuppressive medication. The link between baseline parameters and the immunosuppressive response was investigated using nonparametric measures of association and multivariate logistic regression.
There was a trend toward greater progression among men, ever smokers, those negative for antisynthetase antibodies, and those with the typical interstitial pneumonia radiographic pattern, but no statistically significant relationship between baseline serological, clinical, or morphological features and response to immunosuppression was found. Patients who received mycophenolate mofetil and prednisone in combination showed less disease progression (P=0.018) than those who received neither of these drugs.
Baseline clinical evaluation did not predict which patients with IPAF would respond to immunosuppressive medication in the group. In patients with IPAF, including those with IPAF–usual interstitial pneumonia, combination treatment with mycophenolate mofetil and prednisone was linked with a lack of disease progression. Additional research was required to determine which patients with IPAF would benefit from immunosuppressive medication, antifibrotic therapy, or a combination of the two.
