Chest
Original ResearchInterstitial Lung DiseaseEffect of Mycophenolate Mofetil on Pulmonary Function in Scleroderma-Associated Interstitial Lung Disease
Section snippets
Materials and Methods
After approval by the Institutional Review Board and waiver of informed consent, patients were retrospectively identified who met American College of Rheumatology criteria for systemic sclerosis and were treated with MMF. Patients included in the study had a diagnosis of SSc-ILD (defined as abnormal high-resolution CT [HRCT] of the chest consistent with SSc-ILD and no other cause for interstitial lung disease apparent), received > 1 g/d of MMF for at least 6 months, and had measurements of VC
Case Identification
Twenty-three patients met criteria for systemic sclerosis and were treated with MMF. Ten of the 23 patients who received MMF did not meet criteria for inclusion because interstitial lung disease was not present (1 patient), pulmonary function tests were not available (1 patient), or MMF was not used for > 6 months (8 patients). Of those who used MMF for < 6 months, one patient stopped treatment due to nausea, one patient died of an unknown cause, two patients stopped treatment due to personal
Discussion
These data suggest that MMF improves VC in patients with SSc-ILD. MMF was associated with a statistically significant improvement in VC, reversing a significant decline in VC prior to starting MMF. In contrast, Dlco did not change significantly during MMF treatment.
The magnitude of the increase in VC was small and of questionable clinical significance. Although VC improved in 11 of 13 patients during MMF treatment, only 1 or 2 of those patients (depending on the method of analysis) achieved an
ACKNOWLEDGMENT
The authors wish to thank Amanda Mondt for assistance with data abstraction and Shannon Greer for assistance with manuscript preparation.
References (29)
- et al.
Mycophenolate mofetil and its mechanisms of action
Immunopharmacology
(2000) - et al.
Mycophenolate mofetil inhibits intimal hyperplasia and attenuates the expression of genes favouring smooth muscle cell proliferation and migration
Transplant Proc
(2005) - et al.
Mycophenolate mofetil impairs the integrity of colonic anastomosis
J Surg Res
(2006) - et al.
Use of mycophenolate mofetil to treat scleroderma-associated interstitial lung disease
Respir Med
(2008) - et al.
Mycophenolate mofetil is safe, well tolerated, and preserves lung function in patients with connective tissue disease-related interstitial lung disease
Chest
(2006) - et al.
New developments in scleroderma interstitial lung disease
Curr Opin Rheumatol
(2005) - et al.
Comparison of disease progression and mortality of connective tissue disease-related interstitial lung disease and idiopathic interstitial pneumonia
Arthritis Rheum
(2005) - et al.
Cyclophosphamide is associated with pulmonary function and survival benefit in patients with scleroderma and alveolitis
Ann Intern Med
(2000) - et al.
Cyclophosphamide pulse regimen in the treatment of alveolitis in systemic sclerosis
J Rheumatol
(2002) - et al.
Low-dose intravenous cyclophosphamide in systemic sclerosis: an open prospective efficacy study in patients with early diffuse disease
Scand J Rheumatol
(2006)
Oral cyclophosphamide improves pulmonary function in scleroderma patients with fibrosing alveolitis: experience in one centre
Clin Rheumatol
Severe restrictive lung disease in systemic sclerosis
Arthritis Rheum
A randomized unblinded trial of cyclophosphamide versus azathioprine in the treatment of systemic sclerosis
Clin Rheumatol
Cyclophosphamide versus placebo in scleroderma lung disease
N Engl J Med
Cited by (0)
The authors have no conflicts of interest to disclose.