Am. J. Respir. Crit. Care Med., Volume 158, Number 1, July 1998, 220-225

Colchicine versus Prednisone in the Treatment of Idiopathic Pulmonary Fibrosis
A Randomized Prospective Study

WILLIAM W. DOUGLAS, JAY H. RYU, STEPHEN J. SWENSEN, KENNETH P. OFFORD, DARRELL R. SCHROEDER, GAIL M. CARON, RICHARD A. DEREMEE, and Members of the Lung Study Group ^*

Division of Pulmonary and Critical Care Medicine, Department of Diagnostic Radiology, and Section of Biostatistics, Mayo Foundation, Rochester, Minnesota

Twenty-six symptomatic subjects with clinical evidence plus either high-resolution computed tomography (HRCT, n = 25) or open-lung biopsy (OLB, n = 1) patterns typical for idiopathic usual interstitial pneumonia (idiopathic UIP) were entered into a randomized prospective treatment trial using high-dose prednisone (n = 12) versus colchicine (n = 14). The minimum dose of prednisone used was 60 mg/d for 1 mo, tapered to 40 mg/d over the second month, tapered to 40 mg every other day during the third month, with subsequent doses adjusted as clinically indicated. The dose of colchicine was 0.6-1.2 mg/d, as tolerated. The presence of a rim of subpleural honeycomb change was present in all of the 25 subjects who had HRCT. Subjects treated with high-dose prednisone alone experienced a higher incidence of serious side effects and also exhibited a trend (not statistically significant, p = 0.391) to more rapid decline of pulmonary function and shortened survival than did those treated with colchicine alone. In most subjects with typical clinical and HRCT features of idiopathic UIP, neither prednisone nor colchicine resulted in objective improvement, and the disease continued to progress in the majority. Colchicine appears to be a safer alternative to a trial of high-dose prednisone but may be no different than no therapy.

This article has been cited by other articles:

				J. P. Lynch III Idiopathic Pulmonary Fibrosis, Nonspecific Interstitial Pneumonia/Fibrosis, and Sarcoidosis ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 635 - 686. [Full Text] [PDF]

				R. Kim and K. C. Meyer Review: Therapies for interstitial lung disease: past, present and future Therapeutic Advances in Respiratory Disease, October 1, 2008; 2(5): 319 - 338. [Abstract] [PDF]

				A U Wells, N Hirani, and on behalf of the BTS Interstitial Lung Disease Gui Interstitial lung disease guideline Thorax, September 1, 2008; 63(Suppl_5): v1 - v58. [Full Text] [PDF]

				P. Rogliani, M. Mura, M. Assunta Porretta, and C. Saltini Review: New perspectives in the treatment of idiopathic pulmonary fibrosis Therapeutic Advances in Respiratory Disease, April 1, 2008; 2(2): 75 - 93. [Abstract] [PDF]

				S. D. Nathan Therapeutic Intervention: Assessing the Role of the International Consensus Guidelines Chest, November 1, 2005; 128(5_suppl_1): 533S - 539S. [Abstract] [Full Text] [PDF]

				K R Flaherty, E L Thwaite, E A Kazerooni, B H Gross, G B Toews, T V Colby, W D Travis, J A Mumford, S Murray, A Flint, et al. Radiological versus histological diagnosis in UIP and NSIP: survival implications Thorax, February 1, 2003; 58(2): 143 - 148. [Abstract] [Full Text] [PDF]

				H. R. Collard and T. E. King Jr Demystifying Idiopathic Interstitial Pneumonia Arch Intern Med, January 13, 2003; 163(1): 17 - 29. [Abstract] [Full Text] [PDF]

				R. Vassallo, E. Matteson, and C. F. Thomas Jr Clinical Response of Rheumatoid Arthritis-Associated Pulmonary Fibrosis to Tumor Necrosis Factor-{alpha} Inhibition* Chest, September 1, 2002; 122(3): 1093 - 1096. [Abstract] [Full Text] [PDF]

				R. Hubbard and A. Venn The impact of coexisting connective tissue disease on survival in patients with fibrosing alveolitis Rheumatology, June 1, 2002; 41(6): 676 - 679. [Abstract] [Full Text] [PDF]

				T. J. Gross and G. W. Hunninghake Idiopathic Pulmonary Fibrosis N. Engl. J. Med., August 16, 2001; 345(7): 517 - 525. [Full Text] [PDF]

				R.M. du Bois and A.U. Wells Cryptogenic fibrosing alveolitis/idiopathic pulmonary fibrosis Eur. Respir. J., July 1, 2001; 18(32_suppl): 43S - 55s. [Abstract] [Full Text] [PDF]

				S.-J. Yong, A. Adlakha, and A. H. Limper Circulating Transforming Growth Factor-{beta}1 : A Potential Marker of Disease Activity During Idiopathic Pulmonary Fibrosis Chest, July 1, 2001; 120 (2009): 68S - 70S. [Full Text] [PDF]

				M. Selman, T. E. King Jr., and A. Pardo Idiopathic Pulmonary Fibrosis: Prevailing and Evolving Hypotheses about Its Pathogenesis and Implications for Therapy Ann Intern Med, January 16, 2001; 134(2): 136 - 151. [Abstract] [Full Text] [PDF]

				S. C Bourke and H. Clague Review of cryptogenic fibrosing alveolitis, including current treatment guidelines Postgrad. Med. J., October 1, 2000; 76(900): 618 - 624. [Full Text]

				J. E. Michaelson, S. M. Aguayo, and J. Roman Idiopathic Pulmonary Fibrosis : A Practical Approach for Diagnosis and Management Chest, September 1, 2000; 118(3): 788 - 794. [Full Text] [PDF]

				W. W. DOUGLAS, J. H. RYU, and D. R. SCHROEDER Idiopathic Pulmonary Fibrosis . Impact of Oxygen and Colchicine, Prednisone, or No Therapy on Survival Am. J. Respir. Crit. Care Med., April 1, 2000; 161(4): 1172 - 1178. [Abstract] [Full Text]

				T. King Idiopathic Pulmonary Fibrosis: Diagnosis and Treatment . International Consensus Statement Am. J. Respir. Crit. Care Med., February 1, 2000; 161(2): 646 - 664. [Full Text]

				J. A. Chang, J. R. Curtis, D. L. Patrick, and G. Raghu Assessment of Health-Related Quality of Life in Patients With Interstitial Lung Disease Chest, November 1, 1999; 116(5): 1175 - 1182. [Abstract] [Full Text] [PDF]

				R. J. MASON, M. I. SCHWARZ, G. W. HUNNINGHAKE, and R. A. MUSSON Pharmacological Therapy for Idiopathic Pulmonary Fibrosis . Past, Present, and Future Am. J. Respir. Crit. Care Med., November 1, 1999; 160(5): 1771 - 1777. [Full Text]

				D. M Mitchell and A. Woodcock Introduction Thorax, August 1, 1999; 54(90002): S1 - 1. [PDF]

				G. RAGHU, W. CRAIG JOHNSON, D. LOCKHART, and Y. MAGETO Treatment of Idiopathic Pulmonary Fibrosis with a New Antifibrotic Agent, Pirfenidone . Results of a Prospective, Open-label Phase II Study Am. J. Respir. Crit. Care Med., April 1, 1999; 159(4): 1061 - 1069. [Abstract] [Full Text] [PDF]

				B. T. SOCIETY and S. O. C. COMMITTEE The Diagnosis, Assessment and Treatment of Diffuse Parenchymal Lung Disease in Adults---British Thoracic Society recommendations Thorax, April 1, 1990; 54(90001): 1S - 28. [Full Text]