{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:40:15Z","timestamp":1786974015427,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T00:00:00Z","timestamp":1531699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ministry of Health, Labour and Welfare of Japan"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Corticosteroids and immunosuppressive agents are considered mainstays of therapy for connective tissue disease\u2010related interstitial lung disease (CTD\u2010ILD); however, tacrolimus with corticosteroid therapy has not been fully investigated. Our objectives were to examine the multidimensional therapeutic benefit and tolerability of the combined therapy for the initial treatment of patients with CTD\u2010ILD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective case series, we identified consecutive CTD\u2010ILD patients treated with tacrolimus plus intravenous (i.v.) methylprednisolone (1000\u2009mg i.v. 3\u2009days a week for 2\u2009weeks) followed by low\u2010dose prednisolone (10\u2009mg\/day). We assessed the multidimensional therapeutic benefit and tolerability including lung physiology, exercise capacity, exercise oxygen desaturation, modified Medical Research Council (MMRC) and St George's Respiratory Questionnaire (SGRQ).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 26 ILD patients with the underlying CTD diagnoses included 11 with rheumatoid arthritis, 9 with dermatomyositis, 4 with Sj\u00f6gren's syndrome and 2 others. From baseline to 12\u2009months, the combined therapy significantly improved forced vital capacity (FVC; 77.8% to 94.6%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), diffusing capacity of the lung for carbon monoxide (DL<jats:sub>CO<\/jats:sub>; 66.1% to 75.1%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), 6\u2010min walk distance (6MWD; 530 to 568\u2009m, <jats:italic>P<\/jats:italic>\u2009=\u20090.02), lowest oxygen saturation on pulse oximetry (SpO<jats:sub>2<\/jats:sub>; 85% to 89%, <jats:italic>P<\/jats:italic>\u2009=\u20090.01), MMRC (1.3 to 0.8, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) and SGRQ (38 to 21, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). During the study period, only one patient's therapy was discontinued due to an adverse event and none had a life\u2010threatening adverse event attributed to the combined therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our cohort of CTD\u2010ILD, two courses of pulse dose methylprednisolone therapy followed by prednisone and oral tacrolimus appeared to be well tolerated, and to have multidimensional efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13365","type":"journal-article","created":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T23:45:21Z","timestamp":1531784721000},"page":"1041-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Multidimensional improvement in connective tissue disease\u2010associated interstitial lung disease: Two courses of pulse dose methylprednisolone followed by low\u2010dose prednisone and tacrolimus"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7779-9215","authenticated-orcid":false,"given":"Yasuhiko","family":"Yamano","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine and Allergy Tosei General Hospital  Seto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Allergy Tosei General Hospital  Seto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-5459","authenticated-orcid":false,"given":"Yasuhiro","family":"Kondoh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Allergy Tosei General Hospital  Seto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Ando","sequence":"additional","affiliation":[{"name":"Center for Advanced Medicine and Clinical Research Nagoya University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Allergy Tosei General Hospital  Seto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiki","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Johkoh","sequence":"additional","affiliation":[{"name":"Department of Radiology Kinki Central Hospital of Mutual Aid Association of Public Health Teachers  Itami Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Fukuoka","sequence":"additional","affiliation":[{"name":"Department of Laboratory of Pathology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61079-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055120"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)30152-7"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-199512000-00007"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090048"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.02.006"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00070705"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21240"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pupt.2015.12.004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu166"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110281"},{"key":"e_1_2_8_13_1","unstructured":"SaketkooLA MittooS HuscherD KhannaD DellaripaPF DistlerO FlahertyKR FrankelS OddisCV DentonCPet al.;CTD\u2010ILD Special Interest Group. 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