Open AccessTacrolimus rescue therapy for severe respiratory failure in the anti‐synthetase syndrome
Author(s) -
Rigby Amy L.,
Plit Marshall,
Glanville Allan R.
Publication year - 2014
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.52
Subject(s) - tacrolimus , medicine , calcineurin , salvage therapy , rescue therapy , lung transplantation , interstitial lung disease , respiratory failure , lung , transplantation , chemotherapy
Interstitial lung disease ( ILD ) is the major determinant of morbidity and mortality in the anti‐synthetase syndrome ( ASS ). The therapeutic efficacy of corticosteroids for the ILD component is limited; hence, additional immunosuppressive and immunomodulatory therapies have been tried with a modicum of success in recent years. Tacrolimus, a calcineurin inhibitor, is one potential therapy. We describe four consecutive patients with ASS whom we treated with tacrolimus at a quaternary referral hospital in 2009–2013. All four patients had significant ILD , three had severe and progressive ILD , and two had been referred for consideration of lung transplantation. Tacrolimus use was associated with improvement in ILD in all four patients with a mean follow‐up of 3 years. Our case series adds further evidence to support the use of tacrolimus as salvage therapy for severe respiratory failure due to ILD in ASS , which may be associated with a dramatic and enduring response.