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Type: Journal article
Title: Mycophenolate mofetil is an effective and safe option for the management of systemic sclerosis-associated interstitial lung disease: results from the Australian Scleroderma Cohort study
Author: Owen, C.
Ngian, G.
Elford, K.
Moore, O.
Stevens, W.
Nikpour, M.
Rabusa, C.
Proudman, S.
Roddy, J.
Zochling, J.
Hill, C.
Sturgess, A.
Tymms, K.
Youssef, P.
Sahhar, J.
Citation: Clinical and Experimental Rheumatology, 2016; 34(5 (Suppl.100)):170-176
Publisher: Pacini editore
Issue Date: 2016
ISSN: 0392-856X
Statement of
C. Owen, G. Ngian, K. Elford, O. Moore, W. Stevens, M. Nikpour, C. Rabusa, S. Proudman, J. Roddy, J. Zochling, C. Hill, A. Sturgess, K. Tymms, P. Youssef, J. Sahhar
Abstract: OBJECTIVES: To report the efficacy and tolerability of mycophenolate mofetil (MMF) and azathioprine (AZA) in the management of systemic sclerosis-associated interstitial lung disease (SSc-ILD).METHODS: Patients in the Australian Scleroderma Cohort Study treated with at least 3 months of MMF or AZA for SSc-ILD confirmed on high resolution computed tomography (HRCT) chest were identified and their pulmonary function tests (PFTs) retrieved. Individuals with available results for T-1 (12 months prior to treatment commencement), T0 (date of treatment commencement) and at least one subsequent time point were included in the drug efficacy analysis. The Wilcoxon signed-rank test was used to compare absolute FVC at T1, T0, 12 months (T1), 24 months (T2) and 36 months (T3). Analysis of drug tolerability included all identified patients treated with MMF or AZA. RESULTS: 18/22 patients treated with MMF and 29/49 treated with AZA had adequate PFTs for inclusion in the drug efficacy analysis. Median absolute FVC at T1 for MMF treatment was 2.50L, declining to 2.12L at T0 (p=0.02). Following MMF therapy, FVC results were stable at T1 (2.13L, p=0.86), T2 (2.17L, p=0.65) and T3 (2.25L, p=0.78). In the AZA group, a statistically significant decline did not occur prior to treatment, however FVC results remained stable at T1, T2 and T3.Adverse events leading to early discontinuation (<12 months treatment) were less common in the MMF group (4/22 vs. 13/49). Gastrointestinal complications were the main cause of discontinuation in both groups. CONCLUSIONS: In patients with SSc-ILD with declining pulmonary function, MMF therapy was associated with stability for up to 36 months. Early adverse events leading to discontinuation occurred less frequently in patients treated with MMF than in AZA treated patients.
Keywords: Lung
Lung Diseases, Interstitial
Scleroderma, Systemic
Mycophenolic Acid
Immunosuppressive Agents
Tomography, X-Ray Computed
Respiratory Function Tests
Treatment Outcome
Drug Therapy, Combination
Retrospective Studies
Longitudinal Studies
Time Factors
Databases, Factual
Middle Aged
Description: Published: 13/10/2016. CER8955
Rights: Copyright status unknown
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