{
  "abstract": "Introduction Interstitial lung disease (ILD) is characterised as a group of conditions that cause inflammation and fibrosis in the lung. Cyclophosphamide (CYC) is considered for patients with rapidly worsening ILD to potentially slow down the progression of the lung disease. The use of cyclophosphamide is fraught with concerns due to efficacy and side effects and the decision to treat is based on a risk to benefit ratio.Objectives To assess the role and tolerability of intravenous (IV) pulsed cyclophosphamide in patients with ILD.Methods We retrospectively analysed ILD patients treated with CYC at our centre from 2021 to 2024. Response to treatment was correlated with lung functions and extent of radiological involvement. Scans were analysed by cardiothoracic radiologist based on the extent of ground glass opacity or fibrosis on CT scans. Data are presented as median (IQR).Results A total of 21 patients were included. The median age was 62 years (56–72); 11 were male. Diagnoses included CTD-ILD (n=6), chronic hypersensitivity pneumonitis (n=7), fibrotic NSIP (n=2), fibrotic organising pneumonia (n=3), PR3-positive vasculitis (n=1), progressive sarcoidosis (n=1), and unclassified progressive fibrosis (n=1). The median follow-up duration was 38 (20–61) months.All patients underwent pre-treatment investigation as per requirements. CYC doses ranged from 10–15 mg/kg; everyone received concurrent intravenous pulsed methylprednisolone (500 mg to 1 g daily for 3 days). The median FVC reduced from 2.2 L to 2.1 L, however there was an improvement in FVC predicted% from 59% to 63%. There was no change in the TLCO 39% (33–48%) to 38.5% (20–34%) pre and post treatment. Treatment was discontinued in two patients due to haematuria and neutropenia. Side effects included haematuria, neutropenia, diarrhoea and abdominal pain, nausea, and chest infection. The median duration between treatment initiation and follow-up imaging was 9 (6–14) months. Correlation between lung function and radiology following treatment are shown in table 1.Abstract P29 Table 1Conclusion There was improvement in both FVC and TLCO in patients treated with CYC if the fibrosis is or GGO was < 50% on imaging. The values were difficult to compare in the more extensive group due to small numbers.",
  "authors": [
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "W Soe"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "M Adil Irshad"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "F Thompson"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "A Donaldson"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "M Ball"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "S Ramachandraiah"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "V Titmuss"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "L Newman"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "A Wallis"
    },
    {
      "affiliations": [
        "Portsmouth Hospital University Trust, Portsmouth, UK"
      ],
      "name": "S Babu"
    }
  ],
  "title": "P29 Efficacy of pulsed cyclophosphamide in interstitial lung disease",
  "uid": "ee917923-d5c3-5b83-bf77-80d6e79eea81"
}