Randomized trial of prolonged chloroquine therapy in advanced pulmonary sarcoidosis.
Identifieur interne : 000001 ( Ncbi/Curation ); précédent : 000000; suivant : 000002Randomized 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.
- Adulte, Adulte d'âge moyen, Biopsie, Capacité vitale, Diagnostic par imagerie, Femelle, Humains, Mâle, Poumon, Relation dose-effet des médicaments, Soins de longue durée, Volume expiratoire maximal par seconde, Études de suivi.
English descriptors
- KwdEn :
- Adult, Antirheumatic Agents (administration & dosage), Antirheumatic Agents (adverse effects), Biopsy, Chloroquine (administration & dosage), Chloroquine (adverse effects), Diagnostic Imaging, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Forced Expiratory Volume (drug effects), Humans, Long-Term Care, Lung (drug effects), Lung (pathology), Male, Middle Aged, Sarcoidosis, Pulmonary (diagnosis), Sarcoidosis, Pulmonary (drug therapy), Sarcoidosis, Pulmonary (pathology), 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.
DOI: 10.1164/ajrccm.160.1.9809024
PubMed: 10390399
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Baltzan</name><affiliation wicri:level="4"><nlm:affiliation>Respiratory Division and the Division of Neuro-Ophthalmology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Respiratory Division and the Division of Neuro-Ophthalmology, Royal Victoria Hospital, McGill University, Montreal, Quebec</wicri:regionArea><orgName type="university">Université McGill</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></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">American journal of respiratory and critical care medicine</title><idno type="ISSN">1073-449X</idno><imprint><date when="1999" type="published">1999</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Antirheumatic Agents (administration & dosage)</term><term>Antirheumatic Agents (adverse effects)</term><term>Biopsy</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>Humans</term><term>Long-Term Care</term><term>Lung (drug effects)</term><term>Lung (pathology)</term><term>Male</term><term>Middle Aged</term><term>Sarcoidosis, Pulmonary (diagnosis)</term><term>Sarcoidosis, Pulmonary (drug therapy)</term><term>Sarcoidosis, Pulmonary (pathology)</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="MESH" 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>Soins de longue durée</term><term>Volume expiratoire maximal par seconde</term><term>Études de suivi</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 (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.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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