Randomized trial of prolonged chloroquine therapy in advanced pulmonary sarcoidosis
Identifieur interne : 002710 ( Main/Exploration ); précédent : 002709; suivant : 002711Randomized trial of prolonged chloroquine therapy in advanced pulmonary sarcoidosis
Auteurs : M. Baltzan [Canada] ; S. Mehta ; T. H. Kirkham ; M. G. CosioSource :
- American journal of respiratory and critical care medicine [ 1073-449X ] ; 1999.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Antirhumatismaux (administration et posologie), Antirhumatismaux (effets indésirables), Biopsie, Capacité vitale (), Chloroquine (administration et posologie), Chloroquine (effets indésirables), Diagnostic par imagerie, Femelle, Humains, Mâle, Poumon (), Poumon (anatomopathologie), Relation dose-effet des médicaments, Sarcoïdose pulmonaire (anatomopathologie), Sarcoïdose pulmonaire (diagnostic), Sarcoïdose pulmonaire (traitement médicamenteux), Soins de longue durée, Volume expiratoire maximal par seconde (), Études de suivi.
- MESH :
- administration et posologie : Antirhumatismaux, Chloroquine.
- anatomopathologie : Poumon, Sarcoïdose pulmonaire.
- diagnostic : Sarcoïdose pulmonaire.
- effets indésirables : Antirhumatismaux, Chloroquine.
- traitement médicamenteux : Sarcoïdose pulmonaire.
- Pascal (Inist)
- Adulte, Adulte d'âge moyen, Biopsie, Capacité vitale, Diagnostic par imagerie, Femelle, Humains, Mâle, Poumon, Relation dose-effet des médicaments, Sarcoïdose, Poumon, Soins de longue durée, Stade avancé, Chloroquine, Chimiothérapie, Traitement, Prolongé, Homme, Volume expiratoire maximal par seconde, Études de suivi.
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Advanced stage, Antirheumatic Agents (administration & dosage), Antirheumatic Agents (adverse effects), Biopsy, Chemotherapy, Chloroquine, Chloroquine (administration & dosage), Chloroquine (adverse effects), Diagnostic Imaging, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Forced Expiratory Volume (drug effects), Human, Humans, Long-Term Care, Lung, Lung (drug effects), Lung (pathology), Male, Middle Aged, Prolonged, Sarcoidosis, Sarcoidosis, Pulmonary (diagnosis), Sarcoidosis, Pulmonary (drug therapy), Sarcoidosis, Pulmonary (pathology), Treatment, Vital Capacity (drug effects).
- MESH :
- chemical , administration & dosage : Antirheumatic Agents, Chloroquine.
- chemical , adverse effects : Antirheumatic Agents, Chloroquine.
- diagnosis : Sarcoidosis, Pulmonary.
- drug effects : Forced Expiratory Volume, Lung, Vital Capacity.
- drug therapy : Sarcoidosis, Pulmonary.
- pathology : Lung, Sarcoidosis, Pulmonary.
- Adult, Biopsy, Diagnostic Imaging, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Long-Term Care, Male, Middle Aged.
Abstract
Sarcoidosis may cause severe ventilatory impairment requiring corticosteroid treatment. Chloroquine (CQ) can be an effective treatment for lung sarcoidosis with few side effects, but has not been accepted as standard therapy. We investigated the benefits of prolonged CQ therapy in 23 symptomatic patients with biopsy-proven pulmonary sarcoidosis (duration, ≥ 2 yr). Patients were initially treated for 6 mo with CQ, 750 mg/d, tapering every 2 mo to 250 mg/d. Eighteen patients were then randomized to either a Maintenance group (CQ, 250 mg/d) or to an Observation group (no CQ). After the initial treatment, significant improvement was observed in symptoms, pulmonary function, angiotensin-converting enzyme, and lung gallium scan. Patients randomized to the Maintenance group showed a slower decline in pulmonary function (FEV1, 51.4 ± 28.2 ml/yr [Maintenance] versus 196.3 ± 33.4 ml/yr [Observation], p < 0.02) and had fewer relapses: 2 of 10 patients in the Maintenance group at 29.5 ± 4.9 mo versus 6 of 8 patients in the Observation group at 15.5 ± 2.9 mo. Adverse effects were seen mainly during high-CQ dosage. We conclude that CQ should be an important consideration for the treatment and maintenance of chronic pulmonary sarcoidosis.
Affiliations:
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Le document en format XML
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Baltzan</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Respiratory Division and the Division of Neuro-Ophthalmology, Royal Victoria Hospital, McGill University</s1><s2>Montreal, Quebec</s2><s3>CAN</s3></inist:fA14><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName><orgName type="university">Université McGill</orgName></affiliation></author><author><name sortKey="Mehta, S" sort="Mehta, S" uniqKey="Mehta S" first="S." last="Mehta">S. Mehta</name></author><author><name sortKey="Kirkham, T H" sort="Kirkham, T H" uniqKey="Kirkham T" first="T. H." last="Kirkham">T. H. Kirkham</name></author><author><name sortKey="Cosio, M G" sort="Cosio, M G" uniqKey="Cosio M" first="M. G." last="Cosio">M. G. Cosio</name></author></analytic><series><title level="j" type="main">American journal of respiratory and critical care medicine</title><title level="j" type="abbreviated">Am. j. respir. crit. care med.</title><idno type="ISSN">1073-449X</idno><imprint><date when="1999">1999</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">American journal of respiratory and critical care medicine</title><title level="j" type="abbreviated">Am. j. respir. crit. care med.</title><idno type="ISSN">1073-449X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Advanced stage</term><term>Antirheumatic Agents (administration & dosage)</term><term>Antirheumatic Agents (adverse effects)</term><term>Biopsy</term><term>Chemotherapy</term><term>Chloroquine</term><term>Chloroquine (administration & dosage)</term><term>Chloroquine (adverse effects)</term><term>Diagnostic Imaging</term><term>Dose-Response Relationship, Drug</term><term>Female</term><term>Follow-Up Studies</term><term>Forced Expiratory Volume (drug effects)</term><term>Human</term><term>Humans</term><term>Long-Term Care</term><term>Lung</term><term>Lung (drug effects)</term><term>Lung (pathology)</term><term>Male</term><term>Middle Aged</term><term>Prolonged</term><term>Sarcoidosis</term><term>Sarcoidosis, Pulmonary (diagnosis)</term><term>Sarcoidosis, Pulmonary (drug therapy)</term><term>Sarcoidosis, Pulmonary (pathology)</term><term>Treatment</term><term>Vital Capacity (drug effects)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Antirhumatismaux (administration et posologie)</term><term>Antirhumatismaux (effets indésirables)</term><term>Biopsie</term><term>Capacité vitale ()</term><term>Chloroquine (administration et posologie)</term><term>Chloroquine (effets indésirables)</term><term>Diagnostic par imagerie</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Poumon ()</term><term>Poumon (anatomopathologie)</term><term>Relation dose-effet des médicaments</term><term>Sarcoïdose pulmonaire (anatomopathologie)</term><term>Sarcoïdose pulmonaire (diagnostic)</term><term>Sarcoïdose pulmonaire (traitement médicamenteux)</term><term>Soins de longue durée</term><term>Volume expiratoire maximal par seconde ()</term><term>Études de suivi</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antirheumatic Agents</term><term>Chloroquine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antirheumatic Agents</term><term>Chloroquine</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antirhumatismaux</term><term>Chloroquine</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Poumon</term><term>Sarcoïdose pulmonaire</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Sarcoidosis, Pulmonary</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Sarcoïdose pulmonaire</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Forced Expiratory Volume</term><term>Lung</term><term>Vital Capacity</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Sarcoidosis, Pulmonary</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Antirhumatismaux</term><term>Chloroquine</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Lung</term><term>Sarcoidosis, Pulmonary</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Sarcoïdose pulmonaire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Biopsy</term><term>Diagnostic Imaging</term><term>Dose-Response Relationship, Drug</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Long-Term Care</term><term>Male</term><term>Middle Aged</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Biopsie</term><term>Capacité vitale</term><term>Diagnostic par imagerie</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Poumon</term><term>Relation dose-effet des médicaments</term><term>Sarcoïdose</term><term>Poumon</term><term>Soins de longue durée</term><term>Stade avancé</term><term>Chloroquine</term><term>Chimiothérapie</term><term>Traitement</term><term>Prolongé</term><term>Homme</term><term>Volume expiratoire maximal par seconde</term><term>Études de suivi</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Sarcoidosis may cause severe ventilatory impairment requiring corticosteroid treatment. Chloroquine (CQ) can be an effective treatment for lung sarcoidosis with few side effects, but has not been accepted as standard therapy. We investigated the benefits of prolonged CQ therapy in 23 symptomatic patients with biopsy-proven pulmonary sarcoidosis (duration, ≥ 2 yr). Patients were initially treated for 6 mo with CQ, 750 mg/d, tapering every 2 mo to 250 mg/d. Eighteen patients were then randomized to either a Maintenance group (CQ, 250 mg/d) or to an Observation group (no CQ). After the initial treatment, significant improvement was observed in symptoms, pulmonary function, angiotensin-converting enzyme, and lung gallium scan. Patients randomized to the Maintenance group showed a slower decline in pulmonary function (FEV<sub>1</sub>, 51.4 ± 28.2 ml/yr [Maintenance] versus 196.3 ± 33.4 ml/yr [Observation], p < 0.02) and had fewer relapses: 2 of 10 patients in the Maintenance group at 29.5 ± 4.9 mo versus 6 of 8 patients in the Observation group at 15.5 ± 2.9 mo. Adverse effects were seen mainly during high-CQ dosage. We conclude that CQ should be an important consideration for the treatment and maintenance of chronic pulmonary sarcoidosis.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Québec</li></region><settlement><li>Montréal</li></settlement><orgName><li>Université McGill</li></orgName></list><tree><noCountry><name sortKey="Cosio, M G" sort="Cosio, M G" uniqKey="Cosio M" first="M. G." last="Cosio">M. G. Cosio</name><name sortKey="Kirkham, T H" sort="Kirkham, T H" uniqKey="Kirkham T" first="T. H." last="Kirkham">T. H. Kirkham</name><name sortKey="Mehta, S" sort="Mehta, S" uniqKey="Mehta S" first="S." last="Mehta">S. Mehta</name></noCountry><country name="Canada"><region name="Québec"><name sortKey="Baltzan, M" sort="Baltzan, M" uniqKey="Baltzan M" first="M." last="Baltzan">M. Baltzan</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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