Exposure to Commonly Prescribed Drugs and the Etiology of Cryptogenic Fibrosing Alveolitis

• DOI: 10.1164/ajrccm.157.3.9701093
• Publication Date: 2013-04-04T17:33:32Z
• Authors: RICHARD HUBBARD; ANDREA VENN; CHRIS SMITH; MARIE COOPER; IAN JOHNSTON; JOHN BRITTON
• Keywords: Etiology

Cryptogenic fibrosing alveolitis is an interstitial lung disease of unknown etiology. Since pulmonary fibrosis a recognized, if rare, complication certain drug exposures, including antidepressants, betablockers, antibiotics, anticonvulsants, and nonsteroidal antiinflammatory drugs (NSAIDs), we tested the hypothesis that exposure to these might contribute etiology cryptogenic alveolitis. Lifetime data were collected from general practitioner records for 141 cases 246 age-, sex-, community-matched control subjects Trent region England. Additional on lifetime smoking habits obtained by postal questionnaire. The odds in relation ever NSAIDs calculated conditional logistic regression. For groups significantly associated with alveolitis, subset analyses performed investigate effects individual drugs. was antidepressants (odds ratio [OR] 1.79 [95% CI 1.09–2.95], p = 0.022) specifically imipramine (OR 4.79 [1.50–15.3], 0.01), dothiepin 2.37 [0.99–5.69], 0.05), mianserin 3.27 [1.11–9.61], 0.03). magnitude overall effect not changed excluding all exposures within 5 yr preceding diagnosis 1.62 [0.94–2.77], 0.081), nor strong 5.72 [1.54–21.2], 0.009) 5.58 [1.12–27.8], 0.036). These estimates appreciably affected controlling history. attributable risk antidepressant 9–14%. No significant association noted between four other primary hypothesis. results this study suggest some can cause