Immunosuppressive Therapy for Autoimmune Lung Diseases - 29/10/12

Doi : 10.1016/j.iac.2012.07.001

Keith C. Meyer, MD, MS ^a,^b,^c,^d,^⁎ , Jennifer Bierach, MD ^d
^a UW Lung Transplant & Advanced Pulmonary Disease Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
^b Interstitial Lung Disease Program, Interstitial Lung Disease Clinic, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
^c Adult Cystic Fibrosis Program, Adult Cystic Fibrosis Clinic, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
^d Section of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

Corresponding author. K4/910 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-9988.

Résumé

This article focuses on issues of safety and monitoring when immunosuppressive pharmacologic therapies are prescribed for the treatment of connective tissue disease (CTD)-associated interstitial pneumonias, vasculitides, and bronchiolitis. Prospective, randomized placebo-controlled clinical trials have yet to be performed to evaluate the efficacy and safety of various immunosuppressive agents used to treat patients with CTD-interstitial lung disease or idiopathic interstitial pneumonias other than idiopathic pulmonary fibrosis (idiopathic usual interstitial pneumonia) that are not associated with the presence of CTD. Knowledge of their potential toxicities and interactions with other drugs combined with the adoption of a systematic approach to monitoring therapy can minimize life-threatening reactions.

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Keywords : Autoimmunity, Interstitial lung disease, Connective tissue disorder, Immunosuppressive drug, Lung disease