Cyclophosphamide for Scleroderma Lung Disease

Clinically significant interstitial lung disease affects patients with systemic sclerosis (scleroderma) and is a cause of morbidity and mortality in approximately 40 percent of these patients. 1 Management of this condition remains difficult and controversial. 2 , 3 In this issue of the Journal, Tashkin and colleagues 4 report the results of a multicenter, placebo-controlled trial of oral cyclophosphamide in patients with well-defined, symptomatic scleroderma-related interstitial lung disease and alveolitis. They document small but statistically significant improvements in lung function and symptoms with cyclophosphamide administered over the course of one year — the first positive results of a placebo-controlled trial in this field. How . . .