Idiopathic pulmonary fibrosis - Impact of oxygen and colchicine, prednisone, or no therapy on survival

The clinical records of 487 patients seen at Mayo Clinic Rochester (MCR) du ring 1994 through 1996 who were diagnosed as having idiopathic pulmonary fi brosis of the usual interstitial pneumonia type (IPF/UIP) were reviewed. Co mputed tomography (CT) had been done in 94.7% of patients and surgical open lung biopsy (OLB) in 20.3%. Median survival was 3.2 yr. We compared surviv al as a function of treatment program, based on intent to treat at the time of the initial contact within the study window. Treatment advised included colchicine alone in 167, no therapy in 157, prednisone at maintenance dosa ges alone in 54, colchicine plus prednisone In 71, and other programs in 38 . Oxygen therapy was advised in 133 patients. By univariate analysis, worse survival was associated with prednisone therapy compared with no therapy, and with oxygen therapy compared with no oxygen therapy. However, on multiv ariate analysis, worse survival was associated with older age, mate gender, lower diffusing capacity for carbon monoxide (DLCO), lower alveolar volume (VA), and a history of worsening pulmonary function. When adjustment was m ade for these factors, there was no significant difference in survival betw een those patients treated with colchicine or prednisone and those on no th erapy, and no difference between those on oxygen therapy and those without oxygen.