Published on the Nov. 9, 2015, Rheumatology Network website
By Whitney L.J. Howell
Patients with systemic sclerosis who take cyclophosphamide or mycophenolate mofitil both experience nearly the same decrease in lung scarring, according to a small study.
Neither medication is superior in reducing lung scarring and improving skin tightness. Rheumatologists can now better understand the agents’ safety profiles and know more about how to prescribe them and monitor results to help patients live longer with better lives.
In a presentation given on Nov. 8, at the 2015 ACR/ARHP annual meeting in San Francisco, Calif., University of California-Los Angeles rheumatologist Philip Clements, MD, revealed patients with systemic sclerosis experienced equivalent improvement with interstitial lung disease when taking both cyclophosphamide and mycophenolate mofitil.
“Both medications have now been shown to be effective in slowing down the scarring of the lungs in fibrosis,” Clements said. “Hopefully, this will leave patients with less breathlessness, less new fibrosis, more functionality, and longer lives. That’s what we’d really like to see happen.”
Overall, Clements said, 70 percent of patients achieved improved vital capacity in lung function, and 70 percent with thick skin experienced skin softening and thinning for improved joint function.
All total, 106 participants were divided into two groups: (1) oral cyclophosphamide 2kg/mg/day for a year, followed by a placebo and (2) oral mycophenolate mofitial 2kg/mg/day up to 1,500 mg BID for two years. Baseline characteristics for both groups were the same.
At study’s end, improvements in forced vital capacity were roughly the same. In the transition dyspnea index, there was an increase of 2.24 with cyclophosphamide versus 1.86 with mycophenolate mofitil. With modified Rodnan skin scoring, there was a decline of 6.1 with cyclophosphamide versus 2.9 with mycophenolate mofitil.
Nearly twice as many participants taking cyclophosphamide came off the medication for intolerance versus those taking mycophenolate mofitil.
To read the story at its original location: http://www.rheumatologynetwork.com/acr2015-rn/lung-scarring-systemic-sclerosis
