PANTHER-IPF
Prednisone, Azathioprine and N-Acetylcysteine in IPF
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In patients with idiopathic pulmonary fibrosis, prednisone + azathioprine + NAC increased mortality and hospitalisation compared with placebo.
N
155
Schéma
Three-arm RCT, stopped early
Critère
Primary: change in FVC over 60 weeks (death/hospitalisation secondary)
Pertinence
1
RésultatCombination vs placebo: 8 vs 1 deaths (P=0.01), 23 vs 7 hospitalisations (P<0.001); death-or-hospitalisation HR 12.11 (95% CI 2.83-51.85). Arm stopped early. NAC monotherapy no benefit (2014).
Idiopathic Pulmonary Fibrosis Clinical Research Network. N Engl J Med. 2012;366(21):1968-1977. 10.1056/NEJMoa1113354
Discussion et critique
Definitively ended the use of immunosuppression in IPF and reshaped guidelines.