Monday, 20 May 2019

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Calcineurin Inhibitors in Anti-Synthetase Dermatomyositis ILD

A pilot treatment study of patients with anti-aminoacyl-tRNA synthetase antibody–positive polymyositis/dermatomyositis-associated interstitial lung disease (anti-ARS-PM/DM-ILD) shows therapy with glucocorticoids and calcineurin inhibitors (CNI) to be highly effective. 

A cohort of 32 consecutive ARS-PM/DM-ILD patients were studied over time to assess the efficacy of first-line prednisolone (PSL) plus CNI therapy was compared with that of PSL alone using propensity score–matched analysis. Progression free survival (PFS) was was defined as no deterioration in PM/DM-ILD (including recurrence). 

Patients were randomized to with PSL + CNI (n=20) and PSL (n=12).

For all patients the 2-year PFS was 69% and the 5-year survival rate was 96.9%. The 2-year PFS rate was significantly higher in the matched PSL + CNI group than in the matched PSL group.

The 5-year survival rates of both the matched PSL + CNI and PSL groups were favorable.

First-line PSL + CNI therapy in ARS-PM/DM-ILD patients yieleded better PFS compared with PSL monotherapy, yet there was no significant difference regarding longterm survival.

The author has no conflicts of interest to disclose related to this subject

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