| アブストラクト | BACKGROUND: There is currently no recognized treatment for acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF), and the effect of cyclosporine A in patients with AE-IPF remains unknown. METHODS: We identified patients with AE-IPF who received high-dose methylprednisolone plus cyclosporine A or high-dose methylprednisolone alone from July 1, 2010, to March 31, 2014, using the Diagnosis Procedure Combination database in Japan. We compared in-hospital mortality between patients with and without cyclosporine A by multivariable logistic regression analysis, with adjustment for patient and hospital covariates. Unmeasured confounders were accounted for by instrumental variable analysis based on differential distance. RESULTS: Eligible patients (n=7,989) were divided into a high-dose methylprednisolone plus cyclosporine A group (n=384) and a high-dose methylprednisolone alone group (n=7,605). There was no significant difference in terms of in-hospital mortality between the groups according to multivariable logistic regression [odds ratio, 1.27; 95% confidence interval (CI), 0.99-1.64; P=0.06] or instrumental variable analysis (odds ratio, 0.94; 95% CI, 0.12-7.67; P=0.96). CONCLUSIONS: Cyclosporine A did not reduce in-hospital mortality in patients with AE-IPF. Randomised controlled studies are required to confirm this apparent lack of effect of cyclosporine A in AE-IPF. |
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| ジャーナル名 | Journal of thoracic disease |
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| Pubmed追加日 | 2018/11/13 |
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| 投稿者 | Aso, Shotaro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30416775/ |
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