{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1362262944033124992.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1164/ajrccm/144.2.291"}},{"identifier":{"@type":"URI","@value":"https://academic.oup.com/ajrccm/article-pdf/144/2/291/67644205/ajrccm_144_2_291.pdf"}}],"dc:title":[{"@value":"Azathioprine Combined with Prednisone in the Treatment of Idiopathic Pulmonary Fibrosis: A Prospective Double-blind, Randomized, Placebo-controlled Clinical Trial"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:title>Abstract</jats:title>\n                  <jats:p>Twenty-seven newly diagnosed patients with idiopathic pulmonary fibrosis (IPF) who were previously untreated for IPF were enrolled in a prospective, double-blind, randomized, placebo-controlled study to compare the therapeutic effect of combined prednisone/azathioprine (n = 14) with prednisone plus placebo (n = 13). Prednisone was started at 1.5 mg/kg/day (not to exceed 100 mg/day) for the first 2 wk followed by a biweekly taper to a maintenance dose of 20 mg/day. Azathioprine was administered at a daily dose of 3 mg/kg (not to exceed 200 mg/day). The patients tolerated the use of azathioprine well with few associated side effects. Changes in lung function at 1 yr, as measured by resting alveolar-arterial oxygen difference P[a-a]O2, FVC, and single breath diffusing capacity for carbon monoxide (Dl  COSB), were all somewhat better in the azathioprine/prednisone group compared with the prednisone alone group, although none of these comparisons were statistically significant. Six of 14 (43%) patients randomized to prednisone plus azathioprine died during the 9-yr follow-up period, compared with 10 of 13 (77%) patients randomized to prednisone plus placebo. A Cox model survival analysis shows a nonsignificant but potentially large survival advantage for azathioprine/prednisone (hazard ratio 0.48, with 95% confidence interval increasing from 0.17 to 1.38). When adjusted for age, the survival advantage of azathioprine/prednisone becomes marginally significant (hazard ratio 0.26, with 95% confidence interval increasing from 0.08 to 0.88; p = 0.02 by large sample approximation, p = 0.05 by randomization test). We conclude that combined prednisone and azathioprine is a safe and possibly effective regimen for the treatment of IPF. A larger randomized study to confirm the results shown here is clearly indicated.</jats:p>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1382262944033124992","@type":"Researcher","foaf:name":[{"@value":"Ganesh Raghu"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033124997","@type":"Researcher","foaf:name":[{"@value":"William J. Depaso"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033124999","@type":"Researcher","foaf:name":[{"@value":"Kevin Cain"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033124994","@type":"Researcher","foaf:name":[{"@value":"Samuel P. Hammar"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033125000","@type":"Researcher","foaf:name":[{"@value":"Claude E. Wetzel"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033124993","@type":"Researcher","foaf:name":[{"@value":"David F. Dreis"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033124995","@type":"Researcher","foaf:name":[{"@value":"John Hutchinson"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033124998","@type":"Researcher","foaf:name":[{"@value":"Neeley E. Pardee"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]},{"@id":"https://cir.nii.ac.jp/crid/1382262944033124996","@type":"Researcher","foaf:name":[{"@value":"Richard H. Winterbauer"}],"jpcoar:affiliationName":[{"@value":"From the Departments of Medicine, Biostatistics, and Pathology, the University of Washington Medical Center, and the Virginia Mason Medical Center, Seattle, Washington"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"00030805"}],"prism:publicationName":[{"@value":"American Review of Respiratory Disease"}],"dc:publisher":[{"@value":"Oxford University Press (OUP)"}],"prism:publicationDate":"1991-08-01","prism:volume":"144","prism:number":"2","prism:startingPage":"291","prism:endingPage":"296"},"reviewed":"false","dc:rights":["https://academic.oup.com/pages/standard-publication-reuse-rights"],"url":[{"@id":"https://academic.oup.com/ajrccm/article-pdf/144/2/291/67644205/ajrccm_144_2_291.pdf"}],"createdAt":"2011-08-03","modifiedAt":"2026-03-30","relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360567182431367552","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Japanese guideline for the treatment of idiopathic pulmonary fibrosis"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567184739249408","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Antifibrotic effects of cyclosporine A on TGF‐β1–treated lung fibroblasts and lungs from bleomycin‐treated mice: role of hypoxia‐inducible factor‐1α"}]}],"dataSourceIdentifier":[{"@type":"CROSSREF","@value":"10.1164/ajrccm/144.2.291"},{"@type":"CROSSREF","@value":"10.1096/fj.201601357r_references_DOI_7VfeV02ooJVG1MA6rV7HIEaQC4a"},{"@type":"CROSSREF","@value":"10.1016/j.resinv.2018.03.003_references_DOI_7VfeV02ooJVG1MA6rV7HIEaQC4a"}]}