Cyclosporin treatment in steroid-resistant and acutely exacerbated interstitial pneumonia

Intern Med. 2005 Nov;44(11):1144-50. doi: 10.2169/internalmedicine.44.1144.


Objective: The aim of this study was to evaluate the efficacy of cyclosporin A (CsA) in patients with interstitial pneumonia (IP).

Design: Retrospective comparative study.

Patients: We reviewed 33 patients (23 males and 10 females with a mean age of 62.5 years) with histologically-proven progressive IP who were treated with CsA. All patients had corticosteroid-resistant IP or developed acute exacerbation of IP in their courses.

Results: The underlying systemic diseases were: idiopathic interstitial pneumonias (IIPs) in 19 patients, and collagen vascular diseases (CVDs) in 14. The histopathological patterns and underlying diseases of IP were classified as usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) in 10 patients, cellular-nonspecific interstitial pneumonia (NSIP)/IIPs in 3, fibrotic-NSIP/IIPs in 5, organizing pneumonia (OP)/IIP in 1, UIP/CVDs in 4, cellular-NSIP/CVDs in 7, fibrotic-NSIP/CVDs in 2, and diffuse alveolar damage (DAD)/CVD in 1, respectively. They received a low dosage of CsA combined with corticosteroids. The prognoses after treatment with CsA were well correlated with histopathological patterns. Cellular-NSIP and OP showed better prognoses than fibrotic-NSIP, UIP or DAD. In addition, CVDs had better prognoses than IIPs, when compared on the basis of the same histopathological patterns. Furthermore, the prognoses in the CsA-treated group were significantly better than in those without CsA treatment in regard to acute exacerbation of UIP/IPF.

Conclusions: CsA combined with corticosteroids may be an efficacious treatment for corticosteroid-resistant IP and for acute exacerbation of IPF.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Cyclosporine / therapeutic use*
  • Drug Resistance
  • Female
  • Follow-Up Studies
  • Glucocorticoids / adverse effects*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / mortality
  • Male
  • Middle Aged
  • Respiratory Function Tests
  • Retrospective Studies
  • Survival Rate
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclosporine