Abstract
BackgroundRelapse of cryptogenic organizing pneumonia (COP) may lead to poor long-term prognosis and necessitates multiple rounds of steroid treatment with potential adverse effects. The objective of this study is to identify predictive factors of COP relapse by comparing demographic and clinical variables between relapse and non-relapse groups.MethodsDuring 2008–2013, 33 COP patients were treated, of which 23 (69.7%) and 10 patients (30.3%) were assigned to the non-relapse and relapse group, respectively. From medical records, we compared the following variables at initial episode: clinical characteristics, serum parameters, chest CT scan findings, and steroid treatment.ResultsClinical characteristics, cumulative prednisone dose, and steroid treatment duration were similar between groups. In univariate analysis, alternatively, the proportion of patients with bilateral shadow pattern, traction bronchiectasis, and partial remission after steroid treatment was significantly higher in the relapse group. These differences were not significant by multivariate Cox regression analysis.ConclusionsWe identified radiographic findings, such as bilateral shadow pattern, traction bronchiectasis, and partial remission, may have possibility of predictive factors for COP relapse. Larger-scale studies are required to confirm if any are independent predictors of COP relapse.
Highlights
Relapse of cryptogenic organizing pneumonia (COP) may lead to poor long-term prognosis and necessitates multiple rounds of steroid treatment with potential adverse effects
Organizing pneumonia is classified as either cryptogenic OP (COP), which has no specific etiology, or secondary OP caused by an inflammatory reaction to drugs, infection, collagen vascular disease, malignancy, or radiation therapy [2,3,4]
The purpose of this study is to identify predictive factors for relapse of COP by comparing the clinical characteristics, laboratory data, radiographic findings, duration of steroid treatment, cumulative equivalent dose of prednisone, and response to steroid therapy between non-relapse and relapse groups
Summary
Relapse of cryptogenic organizing pneumonia (COP) may lead to poor long-term prognosis and necessitates multiple rounds of steroid treatment with potential adverse effects. The objective of this study is to identify predictive factors of COP relapse by comparing demographic and clinical variables between relapse and non-relapse groups. Organizing pneumonia is classified as either cryptogenic OP (COP), which has no specific etiology, or secondary OP caused by an inflammatory reaction to drugs, infection, collagen vascular disease, malignancy, or radiation therapy [2,3,4]. A relationship between relapse and steroid dose was identified [10, 11], and guidelines for steroid treatment have been proposed by Epler [3] and Schwartz and King [4]. Schwartz and King suggested initiating therapy with 1–1.5 mg/kg/day prednisone for 4–8 weeks, tapering to 0.5–1 mg/kg/day
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