A prospective open-label study of mycophenolate mofetil for the treatment of diffuse systemic sclerosis

被引:69
作者
Derk, Chris T. [1 ]
Grace, Elizabeth [1 ]
Shenin, Max [1 ]
Naik, Manisha [1 ]
Schulz, Steffan [1 ]
Xiong, Wen [1 ]
机构
[1] Thomas Jefferson Univ, Div Rheumatol, Philadelphia, PA 19107 USA
关键词
Mycophenolate mofetil; Mycophenolic acid; Fibrosis; Systemic sclerosis; Scleroderma; Treatment; D-PENICILLAMINE; SCLERODERMA; CYCLOPHOSPHAMIDE; THERAPY;
D O I
10.1093/rheumatology/kep295
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To evaluate the efficacy and safety of mycophenolate mofetil for the treatment of SSc. Methods. We recruited 15 patients with dcSSc to take part in an open-label study using mycophenolate mofetil to treat their disease over a 12-month period. The primary outcome measure was the modified Rodnan skin score (mRSS), whereas secondary outcomes included the Medsger severity score, pulmonary function studies, 2D echocardiograms and the Short Form Health Survey (SF)-36 questionnaire. Results. The mRSS significantly improved in those patients who tolerated the medication for > 3 months (P < 0.0001), and there was a statistically significant improvement in the Medsger severity scores of the general (P = 0.05), peripheral vascular involvement (P = 0.05) and skin (P = 0.0003) scores. The SF-36 scores improved (P = 0.05) and the pulmonary function studies showed a trend towards improvement, though not of statistical significance. The mean pulmonary artery pressure by 2D echocardiography did not change. Conclusions. In this prospective open-label study of mycophenolate mofetil for the treatment of dcSSc, we observed significant improvements in skin scores, peripheral vascular involvement and patient-perceived health status. Pulmonary function studies did not worsen as expected, but instead showed a trend towards improvement. Controlled trials are needed to further investigate this trend for improved pulmonary function studies.
引用
收藏
页码:1595 / 1599
页数:5
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