COLCHICINE VERSUS PREDNISONE AS TREATMENT OF USUAL INTERSTITIAL PNEUMONIA

Objective: To assess the results with colchicine and prednisone as ini tial single-drug therapy in patients with usual interstitial pneumonia (UIP). Material and Methods: We reviewed the serial pulmonary functio n test results in 22 patients with typical clinical and high-resolutio n computed tomographic features of UIP who were treated with colchicin e as initial single-agent therapy and compared them with a group of 22 historical patients with UIP of similar severity diagnosed by open-lu ng biopsy who were given prednisone as initial single-drug therapy. Re sults: No significant difference was detected in the rate of decline o f pulmonary function or in the time to ''failure'' between the two stu dy groups. A trend was suggested for more rapid decline of pulmonary f unction in the prednisone-treated than in the colchicine-treated group . The design of this study does not allow distinction between a possib le beneficial effect of colchicine and a possible adverse effect relat ed to weaning from high-dose prednisone. Colchicine was well tolerated ; few side effects other than mild diarrhea were noted in those patien ts able to take the drug long enough to return for pulmonary function testing at 3 months. In comparison, the side effects of prednisone wer e more serious. and were not always reversible with cessation of thera py. Conclusion: This study lends further support to the assumption tha t colchicine may be a satisfactory and less hazardous substitute for p rednisone in the treatment of patients with UIP.