CHEST
Original Research: Diffuse Lung DiseaseUse of Mycophenolate Mofetil or Azathioprine for the Management of Chronic Hypersensitivity Pneumonitis
Section snippets
Study Population
The study cohort included patients from four different centers with specialized ILD clinics: University of California, San Francisco (UCSF), University of British Columbia (UBC), Centre Hospitalier de l’Université de Montréal (CHUM), and University of Calgary (UCalgary). Patients were identified from prospective ILD databases at UCSF and UBC and from retrospective review of medical records from the ILD clinics at CHUM and UCalgary. Patients were included if they had a multidisciplinary team
Cohort Formation and Study Population
One hundred one patients with a diagnosis of cHP treated with MMF or AZA were identified from the four ILD centers. Of these patients, 31 were excluded (30 from UCSF and one from UBC) due to lack of follow-up data after the initiation of therapy; 70 patients were included in the final cohort (Fig 1). Patients included in the study were younger and more likely to have undergone a surgical lung biopsy than those who were excluded for lack of follow-up. Other baseline characteristics were similar
Discussion
In this multicenter retrospective study, we demonstrated that treatment of cHP with MMF or AZA is associated with improved gas exchange and a reduction in prednisone dose. MMF and AZA appeared well tolerated, with low rates of medication discontinuation and similar adverse effects compared with previous reports.11, 13, 16 To our knowledge, this is the first study to describe the effects of MMF or AZA on the clinical course of cHP.
There is a pressing need to identify alternative therapeutic
Acknowledgments
Author contributions: J. M. takes responsibility for the content of the manuscript, including the data and analysis and is guarantor of this paper. J. M., K. A. J., H. R. C., C. J. R., and B. L. contributed to the conception and design, acquisition of data, and analysis and interpretation of the data. J. M., J. J. S., A. F., and H. R. C. contributed to the analysis and interpretation of the data. C. A., B., M. E., K. D. J., C. D. F., H. M., and B-P. D. contributed to the acquisition of the
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Drs Morisset and Johannson contributed equally to this manuscript.
FUNDING/SUPPORT: This work was supported by the Nina Ireland Program for Lung Health.