BACKGROUND: Immunosuppressive therapy may potentially alter the natural disease course of scleroderma. There have been reports of using mycophenolate mofetil (MMF) for the treatment of scleroderma skin disease. OBJECTIVE: To analyse the experience of using MMF for the treatment of active diffuse cutaneous scleroderma. METHODS: The authors compared the change in mean modified Rodnan skin scores (mRSS) in an MMF cohort at baseline with scores at 3, 6, 9 and 12 months and with those of historical controls from a pooled analysis of three multicentre randomised clinical trials of recombinant human relaxin, d-penicillamine and oral bovine type I collagen. RESULTS: Improvement in mRSS after treatment with MMF compared with baseline was seen as early as 3 months and continued through the 12-month follow-up. The mRSS of the MMF cohort was not different from that of the historical controls at 6 months (MMF -3.05 ± 7.4 vs relaxin -4.83 ± 6.99, p=0.059), but was significantly lower at 12 months (MMF -7.59 ± 10.1 vs d-penicillamine -2.47 ± 8.6, p<0.001; collagen -3.4 ± 7.12, p=0.002). General and muscle severity scores and quality of life measures also improved compared with baseline. Pulmonary function remained stable. CONCLUSIONS: MMF may benefit skin disease in patients with diffuse scleroderma, but prospective studies are required to determine its role.
BACKGROUND: Immunosuppressive therapy may potentially alter the natural disease course of scleroderma. There have been reports of using mycophenolate mofetil (MMF) for the treatment of scleroderma skin disease. OBJECTIVE: To analyse the experience of using MMF for the treatment of active diffuse cutaneous scleroderma. METHODS: The authors compared the change in mean modified Rodnan skin scores (mRSS) in an MMF cohort at baseline with scores at 3, 6, 9 and 12 months and with those of historical controls from a pooled analysis of three multicentre randomised clinical trials of recombinant humanrelaxin, d-penicillamine and oral bovine type I collagen. RESULTS: Improvement in mRSS after treatment with MMF compared with baseline was seen as early as 3 months and continued through the 12-month follow-up. The mRSS of the MMF cohort was not different from that of the historical controls at 6 months (MMF -3.05 ± 7.4 vs relaxin -4.83 ± 6.99, p=0.059), but was significantly lower at 12 months (MMF -7.59 ± 10.1 vs d-penicillamine -2.47 ± 8.6, p<0.001; collagen -3.4 ± 7.12, p=0.002). General and muscle severity scores and quality of life measures also improved compared with baseline. Pulmonary function remained stable. CONCLUSIONS:MMF may benefit skin disease in patients with diffuse scleroderma, but prospective studies are required to determine its role.
Authors: E C LeRoy; C Black; R Fleischmajer; S Jablonska; T Krieg; T A Medsger; N Rowell; F Wollheim Journal: J Rheumatol Date: 1988-02 Impact factor: 4.666
Authors: T A Medsger; A J Silman; V D Steen; C M Black; A Akesson; P A Bacon; C A Harris; S Jablonska; M I Jayson; S A Jimenez; T Krieg; E C Leroy; P J Maddison; M L Russell; R K Schachter; F A Wollheim; H Zacharaie Journal: J Rheumatol Date: 1999-10 Impact factor: 4.666
Authors: Jeffrey J Swigris; Amy L Olson; Aryeh Fischer; David A Lynch; Gregory P Cosgrove; Stephen K Frankel; Richard T Meehan; Kevin K Brown Journal: Chest Date: 2006-07 Impact factor: 9.410
Authors: Ariane L Herrick; Mark Lunt; Nina Whidby; Holly Ennis; Alan Silman; Neil McHugh; Christopher P Denton Journal: J Rheumatol Date: 2009-12-01 Impact factor: 4.666
Authors: J E Pope; M Baron; N Bellamy; J Campbell; S Carette; I Chalmers; P Dales; J Hanly; E A Kaminska; P Lee Journal: J Rheumatol Date: 1995-07 Impact factor: 4.666
Authors: P Clements; P Lachenbruch; J Siebold; B White; S Weiner; R Martin; A Weinstein; M Weisman; M Mayes; D Collier Journal: J Rheumatol Date: 1995-07 Impact factor: 4.666
Authors: Corrie L Poelman; Laura K Hummers; Fredrick M Wigley; Cynthia Anderson; Francesco Boin; Ami A Shah Journal: J Rheumatol Date: 2014-11-29 Impact factor: 4.666