title: Use of mycophenolate mofetil to treat scleroderma-associated interstitial lung disease.
abstract: Up to 80% of patients with scleroderma have lung disease, with interstitial lung disease (ILD) being the most common manifestation. Currently, there is no definitive therapy for this condition. The objective of the study is to investigate the use of mycophenolate mofetil (MMF) to treat scleroderma interstitial ILD. We report a retrospective chart review of 17 patients with scleroderma ILD treated with MMF (2g/day) for at least 12 months. Demographics, bronchoalveolar lavage (BAL) findings, pulmonary physiology and high-resolution computed tomography were recorded at baseline and after 12 and 24 months of therapy. Baseline BAL (n=12) showed alveolitis (median of 18% neutrophils). Ninety-four percent of subjects had either improved or stable lung function after 12 months of treatment: four improved, 12 were stable and only one worsened. All patients had radiographic abnormalities consistent with ILD. After 12 months of therapy, radiological findings (n=15) were stable in 11 patients, worse in three, and improved in one. There were no side effects attributable to MMF therapy recorded. Treatment of patients with scleroderma ILD for up to 24 months with MMF was generally associated with stable pulmonary function. These data argue for a prospective trial using MMF to treat scleroderma ILD.
authors.affiliation: Hospital Universitario Dr. Jose Eleuterio González, Monterrey, NL, Mexico.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Zamora
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Wolters
authors.forename: Harold R
authors.initials: HR
authors.lastname: Collard
authors.forename: M Kari
authors.initials: MK
authors.lastname: Connolly
authors.forename: Brett M
authors.initials: BM
authors.lastname: Elicker
authors.forename: W Richard
authors.initials: WR
authors.lastname: Webb
authors.forename: Talmadge E
authors.initials: TE
authors.lastname: King
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Golden
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012595:Scleroderma, Systemic / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome