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First published October 1, 2005

Interferon Gamma-1b in the Treatment of Idiopathic Pulmonary Fibrosis

Abstract

Abstract

Objective:

To examine the clinical aspects of idiopathic pulmonary fibrosis (IPF) and the efficacy and safety of interferon gamma-1b (IFNγ−1b) in its treatment.

Data Sources:

Epidemiologic, preclinical, and clinical studies published in the English language were identified by a MEDLINE search (1966–January 2005) using the search terms idiopathic pulmonary fibrosis, cryptogenic fibrosing alveolitis, and interferon. Additional citations were identified from the reference lists of related publications.

Study Selection and Data Extraction:

Selected preclinical studies describing the pathophysiologic basis for IFNγ−1b therapy and all clinical studies were included. Additional trials describing other treatment modalities and the determinants of response to therapy in patients with IPF were also reviewed.

Data Synthesis:

IFNγ−1b targets the fibrotic rather than inflammatory processes of IPF. The efficacy of IFNγ−1b in patients with IPF is inconsistent with regard to changes in pulmonary function and mortality, although a modest survival benefit was observed in the largest clinical trial. Adverse events related to IFNγ−1b are frequent although transient. Several cases of respiratory failure occurring subsequent to the administration of IFNγ−1b are documented.

CONCLUSIONS:

To date, although trials suggest that earlier-stage IPF may be responsive to IFNγ−1b, study results overall are inconsistent; further investigation is needed.

Resumen

OBJETIVO:

Examinar los aspectos clínicos de la fibrosis pulmonar idiopática (FPI) y la eficacia y seguridad de su tratamiento con interferón gamma-1b (IFNγ−1b).

FUENTES DE INFORMACIÓN:

Se realizó una búsqueda de literatura, a través del sistema de MEDLINE (1966–enero 2005) y utilizando los términos fibrosis idiopática pulmonar, alveolitis fibrosante criptogénica, e interferon se identificaron estudios epidemiológicos, preclínicos, y clínicos publicados en el idioma inglés. Se identificaron otras referencias utilizando las listas de referencias de las publicaciones.

SELECCIÓN DE ESTUDIOS Y EXTRACCIÓN DE DATOS:

Se incluyeron estudios preclínicos seleccionados y todos los estudios clínicos que describieran la base patofisiológica para la terapia con IFNγ−1b. Se revisaron también estudios clínicos que describieran otras modalidades de tratamiento y factores determinantes para la respuesta a la terapia en pacientes con FPI.

SÍNTESIS:

La acción del IFNγ−1b va dirigida a los procesos fibróticos en lugar de los inflamatorios de la FPI. La eficacia de IFNγ−1b en pacientes con FPI es inconsistente en relación a los cambios en función pulmonar y mortalidad, aunque se observó, en el estudio clínico más grande, un beneficio modesto en sobrevida. Los efectos adversos relacionados al uso de IFNγ−1b son frecuentes, aunque transitorios. Se han documentado en la literatura varios casos de fallo respiratorio luego de la administración de IFNγ−1b.

CONCLUSIONES:

Hasta la fecha, aunque los estudios clínicos sugieren que los pacientes con estadios tempranos de FPI pueden responder a IFNγ−1b, los resultados de los estudios, en general, son inconsistentes y se requiere mayor investigación.
RÉSUMÉ

OBJECTIF:

Examiner les aspects cliniques de la fibrose pulmonaire idiopathique (FPI) ainsi que l'efficacité et l'innocuité de l'interféron gamma-1b (IFNγ−1b) dans son traitement.

SOURCE DE DONNÉES:

Les études épidémiologiques, pré-cliniques, et cliniques publiées en langue anglaise ont été identifiées par une recherche MEDLINE (1966–janvier 2005) avec les mots-clés suivants: idiopathic pulmonary fibrosis, crytogenic fibrosing alveolitis, et interferon. Des références additionnelles ont été identifiées à l'aide des citations et des publications croisées.

SÉLECTION DES ÉTUDES ET EXTRACTION DES DONNÉES:

Les études pré-cliniques décrivant la pathophysiologie et supportant la thérapie avec l'IFNγ−1b de meme que toutes les études cliniques ont été sélectionnées. Des etudes additionnelles décrivant d'autres modalités de traitement et les déterminants de la réponse à la thérapie ont également été revues.

SYNTHÈSE DES DONNÉES:

L'IFNγ−1b cible le processus de fibrose plutôt que le processus inflammatoire. L'efficacité de IFNγ−1b est variable en fonction des changements de la fonction pulmonaire et de la mortalité, bien qu'un bénéfice modeste au niveau de la survie a été observé dans la plus large étude réalisée. Les effets indésirables reliés á l'IFNγ−1b sont fréquents bien que transitoires. Plusieurs cas de défaillance respiratoire suivant ladministration de l'IFNγ−1b ont été documentes dans la littérature.

CONCLUSIONS:

A ce jour, bien que les essais cliniques suggèrent que le stage précoce de la FPI pourrait être traité avec l'IFNγ−1b, les résultats des études sont variables et d'autres données sont requises.

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Published In

Article first published: October 1, 2005
Issue published: October 2005

Keywords

  1. cryptogenic fibrosing alveolitis
  2. idiopathic pulmonary fibrosis
  3. interferon.

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© 2005 SAGE Publications.
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History

Published online: October 1, 2005
Issue published: October 2005
PubMed: 16160001

Authors

Affiliations

Michael A Pacanowski
Michael A Pacanowski PharmD, ASHP-Accredited Pharmacy Practice Resident, Section of Clinical Pharmacology, Department of Pharmaceutical Care Services, Bassett Healthcare, Cooperstown, NY
Guy W Amsden
Guy W Amsden PharmD FCP DABCP, Research Scientist and Clinical Specialist, Section of Clinical Pharmacology, Department of Pharmaceutical Care Services, Bassett Healthcare, Cooperstown

Notes

Reprints: Dr. Amsdem, Clinical Pharmacology Research Center, Bassett Healthcare, One Atwell Rd., Cooperstown, NY 13326-1394, fax 607/547-6914, [email protected]

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