Long-term experience of mycophenolate mofetil for treatment of diffuse cutaneous systemic sclerosis. Issue 6 (6th March 2011)

• Record Type: Journal Article
• Authors: Le, Elizabeth N; Wigley, Fredrick M; Shah, Ami A; Boin, Francesco; Hummers, Laura K
• Is Part Of: Annals of the rheumatic diseases. Volume 70:Issue 6(2011)
• Page Start: 1104
• Page End: 1107
• Publication Date: 2011-03-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2010.142000
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : 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.