Tacrolimus appears well-tolerated, effective in IIM-ILD

Tacrolimus was well-tolerated and effective in the treatment of idiopathic inflammatory myopathies-associated interstitial lung disease (IIM-ILD), according to a retrospective study. In addition, adding low-dose pirfenidone to tacrolimus appears to improve pulmonary involvement for these patients.

In this retrospective study, data were collected and analyzed from 250 hospitalized patients with IIM-ILD divided into 2 groups: tacrolimus alone (n = 93) or other conventional immunosuppressants (n = 157). After adjustment, there was a significantly higher survival rate and a lower relapse rate in patients in the tacrolimus group compared with patients treated with other types of immunosuppressant

In the prospective study, patients with IIM-ILD treated with tacrolimus alone (n = 12) or tacrolimus combined with low-dose pirfenidone (n = 22) were analyzed at baseline, 3, 6, and 12 months.

From baseline to 12 months, there were significant improvements in cardio-pulmonary function, disease activity, muscle strength, and mental scale in patients treated with tacrolimus.

In the subgroup analysis, patients treated with tacrolimus combined with low-dose pirfenidone had lower chest HRCT scores and lower respiratory-related relapse rates than patients in the tacrolimus alone group.

Drug-associated adverse event rates were comparable between the groups; no patients discontinued treatment due to severe adverse events.

Reference
Chen Y, Bai Z, Zhang Z, et al. The efficacy and safety of tacrolimus on top of glucocorticoids in the management of IIM-ILD: A retrospective and prospective study. Front Immunol. 2022;13:978429. doi: 10.3389/fimmu.2022.978429. PMID: 36119045; PMCID: PMC9479328.