A comparative study of treatment with azathioprine or interferon-g for patients with idiopathic pulmonary fibrosis
Fotios Drakopanagiotakis¹, Dimitrios Mermigkis¹, Areti Xifteri¹, Konstantina Tsakanika², Napoleon Karagiannidis¹, Emmanouil Kastanakis¹, Vlassis Polychronopoulos¹, Demosthenes Bouros^3
13rd Department of Pneumonology, Sismanoglio General Hospital, Athens, Greece
²Bronchoalveolar Lavage Unit, Sismanoglio General Hospital, Athens, Greece
³Department of Pneumonology, University Hospital of Alexandroupolis and Medical School, Democritus University of Thrace, Alexandroupolis, Greece

SUMMARY Introduction: Idiopathic pulmonary fibrosis (IPF) is characterized by progressive deterioration of lung function, leading ultimately to death. No pharmacological treatment has been found to stabilize the evolution of the disease, but interferon-g and azathioprine have been used as therapeutic options. Aim: To compare the effectiveness of treatment with interferon-g plus low dose prednisone or azathioprine plus low dose prednisone in patients with IPF. Materials and methods: Patients newly diagnosed with IPF were recruited, 22 in total, of whom 10 received azathioprine plus prednisone and 12 patients received interferon-g plus prednisone for six months. Clinical evaluation, lung function tests, HRCT, bronchoscopy and bronchoalveolar lavage (BAL) were performed at baseline and after six months of treatment. Results: All patients were alive after six months of treatment. No statistically significant difference between the two groups was detected regarding clinical deterioration, inflammatory biomarkers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and BAL cell subpopulations. There was a trend, not statistically significant, towards a greater reduction in forced vital capacity and diffusing capacity for carbon monoxide in the interferon-g group. Conclusion: Interferon-g does not offer any therapeutic advantage over azathioprine as regards the clinical course, lung function tests and BAL cell counts of patients with IPF. Pneumon 2009, 22(3):247-253.
Key words: Idiopathic pulmonary fibrosis, azathioprine, interferon-g, bronchoalveolar lavage.
Correspondence: Demosthenes Bouros MD, FCCP Professor of Pneumonology, Medical School Democritus University of Thrace Director, Department of Pneumonology, University General Hospital, GR-681 00 Alexandroupolis, Greece, Tel. & Fax: +30 2551076106, +302106001213, e-mail: bouros@med.duth.gr

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