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July 13, 2026American Journal of Respiratory and Critical Care Medicine

Mycophenolate and Azathioprine in Fibrotic Interstitial Lung Disease

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Authors

JPJanelle Vu PugashettiAJAdelle S. JeeAYAndrew Reynolds Mansoo Yu

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Overview

Randomized trial evaluates transplant-free survival and lung function in fibrotic ILD with immunosuppression, implying no benefit.

Key Points

  • To assess the effects of mycophenolate and azathioprine on transplant-free survival and lung function in fibrotic interstitial lung disease.
  • Multi-center retrospective study with 2,270 patients
  • Employed clone-censor-weighting framework to simulate randomized controlled trial
  • Primary endpoint was three-year transplant-free survival assessed using weighted Cox models.
  • No improvement in transplant-free survival in any ILD subtype with immunosuppression
  • Higher mortality observed in non-IPF IIP (HR 1.38, 95% CI 1.04-1.84) and fHP (HR 1.62, 95% CI 1.09-2.40)
  • No difference in lung function trajectory across ILD subtypes.

Cite This Study

Pugashetti et al. (2026) studied this question.

synapsesocial.com/papers/6a5482a4475c38bf615a5c43https://doi.org/10.1093/ajrccm/aamag362
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Also Consider

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  4. 4C104-09 Mapping Longitudinal FVC and DLCO Trajectories Across Medication Regimens in Interstitial Pneumonia With Autoimmune Features2026
  5. 5Contemporary Fibrotic Interstitial Lung Disease Outcomes: A Multicentre National Cohort Study2026