A prospective randomized trial of low-dose methylprednisolone combined with N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis

Objective To compare the clinical effect and safety of low-dose methylprenisolone combined with N-acetylcysteine(NAC) and NAC alone in the treatment of idiopathic pulmonary fibrosis(IPF).Methods In this prospective,randomized clinical trial,patients with IPF and ground glass like opacity in HRCT scan in Dapin hospital from Mar 2008 to Sept 2010 were ranmdomly allocated to receive either low-dose methylprenisolone+NAC or NAC alone.Statistical analyses were performed at 12 months postoperatively to compare the PO2,FVC%pred,Dlco/VA%pred,MVV%pred,self-assessment symptom score and adverse reactions between the two groups.Results A total of 25 patients were involved in the statistical analysis,14 patients achieved low-dose methylprenisolone+NAC,and 11 achieved NAC.Significant differences were found in the PO2,Dlco/VA%pred,self-assessment symptom score between two groups(P0.05),and no significant differences were found in the FVC%pred、MVV%pred and adverse reactions between the two groups(P0.05).Conclusion Low-dose methylprenisolone+NAC may have effect in improvement of PO2,pulmonary diffusion function and symptoms without obvious adverse reaction.