Mycophenolate in Scleroderma Lung Disease Save

Clements et al presented the results of their Scleroderma Lung Study II wherein PSS patients with interstitial lung disease were randomized to receive either 3 grams daily of mycopheonolate or 2mg/kg/day of cyclophosphamide. (Citation source: http://buff.ly/1HsOUMH)

142 patients were randomized; 106 completed the 2-year evaluation (more MMF than CYC).

Lung function (FVC) showed comparable improvement in both groups at 24 months. Symptomatic improvements in both groups were noted (TDI, MRSS), but more CYC patients withdrew from study treatment prematurely (36 in CYC and 20 in MMF) (p=0.019).

The need for alternate treatment (MMF, RTX, tocilizimab, IV-CYC) at the end of the study was higher with the CYC group (23%) compared to MMF (4%). Weight loss (NS) and leukopenia/thrombocytopenia (p<0.05) occurred more frequently in the CYC patients. During the study period, there were 11 deaths (15%) in the CYC group and 5 deaths (7%) in the MMF group.

Overall, MMF was equal to CYC (after 2 years) in the improvement in %FVC, and dyspnea symptom indexes, but there were fewer premature withdrawals were noted in the MMF arm.