Relapses in patients treated with corticosteroids

First author [ref.]Patients n#Number relapsedLength of follow-upTime to relapseFatal outcomesAdditional data
Lazor [44]4828 (58%) with ≥1 relapse (68% still under treatment at 1st relapse)35±31 months (median 23)8±9 months (median 5; range 2–46)No deaths attributable to COP or relapse9 (19%) with ≥3 relapses
Relapses beyond 15 months of first relapse were rare
Lohr [45]204 (13%)3.4 years (median)NG10 out of 37 at 10.5 years (5 pulmonary)5-year survival: 73%
Zhou [47]7323 (31.5%)50+27 months (range 9–96 months)≤6 months in 8 of 13 following CS cessationNoneFever, elevated C-reactive protein and worse DLCO associated with relapse
Barroso [48]3318 (56%) out of 32 responding to CS (all responded to additional therapy)54±40 months<6 months in 8 (44%)
≤1 year in 14 (78%)
Mean time to first relapse: 10±12 months (range 2–54)
7 (none due to COP recurrence; infection in 1)Multifocal opacities predicted relapse
Shortened CS maintenance (or lower dose) associated with relapse
More rapid CXR normalisation when treated for relapse
Yoo [49]7314 (19%)38.2 months (range 13–69)NGDisease-related death in 11 patients36 received prednisolone only
37 also received a cytotoxic agent
Zhang [50]5335 (70%)NGNG3 patients50 patients treated with CS
Relapsers responded to increased CS
98.3% 5-year survival
Drakopanagiotakis [51]4013 (43%) out of 30 within 1 yearNGNG1-year mortality: 2 (5.3%)In-hospital mortality 5.7%
Onishi [52]4015 (38%)NGNGNGBAL neutrophilia and high levels of tissue fibrin deposits correlated with relapse
Saito [53]3310 (30.3%)NG476±445 days (range 17–682 days)NGBilateral shadowing and traction bronchiectasis predictive of relapse
Nishino [54]147 (50%)42 (5–84) monthsNGNGRelapse associated with multifocal intra-alveolar fibrin deposits and more extensive involvement on chest imaging

COP: cryptogenic organising pneumonia; NG: not given in manuscript; CS: corticosteroids; DLCO: diffusing capacity of the lung for carbon monoxide; CXR: chest radiograph; BAL: bronchoalveolar lavage. #: patients with COP treated with CS.