Mycophenolate mofetil in systemic sclerosis-associated interstitial lung disease

Κουτρούμπας, Αθανάσιος; Ziogas, Athanassios; Alexiou, Ioannis; Barouta, Georgia; Sakkas, Lazaros I.

doi:10.1007/s10067-010-1498-z

Cited by 65 publications

(45 citation statements)

References 13 publications

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“…To date, only observational studies on the efficacy of MMF have been performed. A recent meta-analysis, encompassing one prospective [54] and four retrospective studies [55][56][57][58], evaluated the safety and efficacy of MMF and mycophenolate sodium [59]. The results of this meta-analysis show that mycophenolate is a safe therapeutic agent and its administration has been linked with stabilisation of lung functional parameters.…”

Section: Nonselective Immunosuppressorsmentioning

confidence: 99%

Interstitial lung disease in systemic sclerosis: where do we stand?

et al. 2015

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Interstitial lung disease (ILD) is common in systemic sclerosis (SSc) patients and despite recent advances in the treatment is, at present, the major cause of death. Today, an early diagnosis of ILD is possible, and is mandatory to improve the prognosis of the disease.Pulmonary function tests and high-resolution computed tomography remain the mainstay for the diagnosis of SSc-ILD, but there is a growing interest in lung ultrasound. Recently, the correlation between severity of fibrosis and some peripheral blood biomarkers has been described.Nonselective immunosuppressors are still the main treatment for ILD, with cyclophosphamide (CYC) most widely used to obtain remission. Novel therapies towards specific molecular and cellular targets have been suggested; in particular, rituximab (RTX) has shown promising results, but further research is needed. It is of paramount importance to define the severity of the disease and the risk of progression in order to define the need for treatment and the treatment intensity. We propose the division of the treatment strategies at our disposal to induce remission into three categories: high intensity (haematopoietic stem cell transplantation), medium intensity (CYC and RTX) and low intensity (azathioprine (AZA) and mycophenolate mofetil (MMF)). After obtaining remission, maintenance treatment with AZA or MMF should be started.In this review we explore new advances in the pathogenesis, diagnosis and treatment of SSc-ILD. @ERSpublications Early diagnosis of ILD is possible, and is mandatory to improve the prognosis of the disease http://ow.ly/P28JHThe relevance of interstitial lung disease in systemic sclerosisPulmonary disease in systemic sclerosis (SSc) mainly comprises interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH). Over the past 40 years the SSc mortality rate has not changed significantly [1]. Nevertheless, while the frequency of deaths due to renal crisis has significantly decreased from 42% to 6%, the proportion of deaths due to ILD and PAH has increased [2]. In fact, ILD and PAH are the two main causes of death in SSc, accounting for 33% and 28% of deaths, respectively [2]. A European Scleroderma Trials and Research group (EUSTAR) analysis revealed, in a cohort of 3656 SSc patients, that ILD is present in 53% of cases with diffuse cutaneous SSc and in 35% of cases with limited

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Section: Nonselective Immunosuppressorsmentioning

confidence: 99%

Interstitial lung disease in systemic sclerosis: where do we stand?

et al. 2015

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“…In a prospective observational one year study of 14 patients who took MMF, 6 patients experienced at least a 10% improvement in their FVC and 5 patients' pulmonary function remained stable [50]. These small studies have had mixed results but, because observed improvements in FVC and DLCO have been documented [50][51][52], larger randomized trials are needed. This drug represents an attractive, less toxic possible alternative to cyclophosphamide.…”

Section: Mycophenolate Mofetilmentioning

confidence: 99%

Interstitial Lung Disease in Systemic Sclerosis: Diagnosis and Management

Schol

Carr²,

Frech³

et al. 2012

Rheumatology

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“…Nevertheless, several reports from small case series describe a positive outcome in SSc-ILD patients treated with MMF, with stabilization or mild improvement of PFTs and HRCT fibrosis after 6 up to 24 months of therapy [84][85][86][87][88]. Stabilization of lung function has also been observed in a recent, uncontrolled, prospective study including early, immunosuppressive therapy-naive dcSSc patients, with a median treatment duration of 18 months [89].…”

Section: Mycophenolatementioning

confidence: 84%