Cryptogenic organizing pneumonia medical therapy: Difference between revisions
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*For asymptomatic mass lesions or nonprogressive disease, treatment is not required, observation is required till they become symptomatic. | *For asymptomatic mass lesions or nonprogressive disease, treatment is not required, observation is required till they become symptomatic. | ||
Standardized regimens of corticosteroids for the symptomatic and progressive disease are: | Standardized regimens of corticosteroids for the symptomatic and progressive disease are: | ||
*Preferred regimen (1) [[Prednisone]] 0.75 mg/kg PO q24h for 4 weeks | *Preferred regimen (1) [[Prednisone]] 0.75 mg/kg PO q24h for 4 weeks. | ||
**Followed by (2) [[Prednisolone]] 0.5 mg/kg PO q24h for 4 weeks | **Followed by (2) [[Prednisolone]] 0.5 mg/kg PO q24h for 4 weeks. | ||
**Followed by (3) [[Prednisolone]] 20mg PO q24h for 4 weeks | **Followed by (3) [[Prednisolone]] 20mg PO q24h for 4 weeks. | ||
**Followed by (4) [[Prednisolone]] 10mg PO q24h for 6 weeks | **Followed by (4) [[Prednisolone]] 10mg PO q24h for 6 weeks. | ||
**Followed by (4) [[Prednisolone]] 5mg PO q24h for 6 weeks before they were stopped | **Followed by (4) [[Prednisolone]] 5mg PO q24h for 6 weeks before they were stopped. | ||
Severe cases: | Severe cases: | ||
*Preferred regimen (1)[[Prednisolone]] 2mg/kg IV q24h for first 3-5 days. | *Preferred regimen (1)[[Prednisolone]] 2mg/kg IV q24h for first 3-5 days. | ||
Followed by same regimen discussed above. | Followed by the same regimen discussed above. | ||
'''Relapses:''' | '''Relapses:''' | ||
*Relapses are very common with corticosteroids therapy. | *Relapses are very common with corticosteroids therapy. | ||
*The predictors of relapses are: | *The predictors of relapses are: | ||
**Delayed treatment | **Delayed treatment. | ||
**Increased gamma-glutamyltransferase levels | **Increased gamma-glutamyltransferase levels. | ||
**Increased alkaline phosphatase levels | **Increased alkaline phosphatase levels. | ||
*Relapses occur while receiving prednisone at 20 mg daily; treat with increasing the dose and decreased as discussed above. | *Relapses occur while receiving prednisone at 20 mg daily; treat with increasing the dose and decreased as discussed above. | ||
Revision as of 22:15, 27 February 2018
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Cryptogenic Organizing Pneumonia Microchapters |
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Differentiating Cryptogenic organizing pneumonia from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
Medical Therapy
- The mainstay of the therapy is pharmacotherapy.
- Corticosteroids are used as first-line treatment for patients with the symptomatic and progressive disease.
- For asymptomatic mass lesions or nonprogressive disease, treatment is not required, observation is required till they become symptomatic.
Standardized regimens of corticosteroids for the symptomatic and progressive disease are:
- Preferred regimen (1) Prednisone 0.75 mg/kg PO q24h for 4 weeks.
- Followed by (2) Prednisolone 0.5 mg/kg PO q24h for 4 weeks.
- Followed by (3) Prednisolone 20mg PO q24h for 4 weeks.
- Followed by (4) Prednisolone 10mg PO q24h for 6 weeks.
- Followed by (4) Prednisolone 5mg PO q24h for 6 weeks before they were stopped.
Severe cases:
- Preferred regimen (1)Prednisolone 2mg/kg IV q24h for first 3-5 days.
Followed by the same regimen discussed above. Relapses:
- Relapses are very common with corticosteroids therapy.
- The predictors of relapses are:
- Delayed treatment.
- Increased gamma-glutamyltransferase levels.
- Increased alkaline phosphatase levels.
- Relapses occur while receiving prednisone at 20 mg daily; treat with increasing the dose and decreased as discussed above.