Mycophenolate mofetil is an effective and safe option for the management of systemic sclerosis-associated interstitial lung disease: results from the Australian Scleroderma Cohort Study
To report the efficacy and tolerability of mycophenolate mofetil (MMF) and azathioprine (AZA) in the management of systemic sclerosis-associated interstitial lung disease (SSc-ILD). Patients in the Australian Scleroderma Cohort Study treated with at least 3 months of MMF or AZA for SSc-ILD confirmed...
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| Veröffentlicht in: | Clinical and experimental rheumatology 2016-09, Vol.34 Suppl 100 (5), p.170-176 |
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| creator | Owen, Claire Ngian, Gene-Siew Elford, Kathleen Moore, Owen Stevens, Wendy Nikpour, Mandana Rabusa, Candice Proudman, Susanna Roddy, Janet Zochling, Jane Hill, Catherine Sturgess, Allan Tymms, Kathleen Youssef, Peter Sahhar, Joanne |
| description | To report the efficacy and tolerability of mycophenolate mofetil (MMF) and azathioprine (AZA) in the management of systemic sclerosis-associated interstitial lung disease (SSc-ILD).
Patients in the Australian Scleroderma Cohort Study treated with at least 3 months of MMF or AZA for SSc-ILD confirmed on high resolution computed tomography (HRCT) chest were identified and their pulmonary function tests (PFTs) retrieved. Individuals with available results for T-1 (12 months prior to treatment commencement), T0 (date of treatment commencement) and at least one subsequent time point were included in the drug efficacy analysis. The Wilcoxon signed-rank test was used to compare absolute FVC at T1, T0, 12 months (T1), 24 months (T2) and 36 months (T3). Analysis of drug tolerability included all identified patients treated with MMF or AZA.
18/22 patients treated with MMF and 29/49 treated with AZA had adequate PFTs for inclusion in the drug efficacy analysis. Median absolute FVC at T1 for MMF treatment was 2.50L, declining to 2.12L at T0 (p=0.02). Following MMF therapy, FVC results were stable at T1 (2.13L, p=0.86), T2 (2.17L, p=0.65) and T3 (2.25L, p=0.78). In the AZA group, a statistically significant decline did not occur prior to treatment, however FVC results remained stable at T1, T2 and T3.Adverse events leading to early discontinuation ( |
| format | Article |
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Patients in the Australian Scleroderma Cohort Study treated with at least 3 months of MMF or AZA for SSc-ILD confirmed on high resolution computed tomography (HRCT) chest were identified and their pulmonary function tests (PFTs) retrieved. Individuals with available results for T-1 (12 months prior to treatment commencement), T0 (date of treatment commencement) and at least one subsequent time point were included in the drug efficacy analysis. The Wilcoxon signed-rank test was used to compare absolute FVC at T1, T0, 12 months (T1), 24 months (T2) and 36 months (T3). Analysis of drug tolerability included all identified patients treated with MMF or AZA.
18/22 patients treated with MMF and 29/49 treated with AZA had adequate PFTs for inclusion in the drug efficacy analysis. Median absolute FVC at T1 for MMF treatment was 2.50L, declining to 2.12L at T0 (p=0.02). Following MMF therapy, FVC results were stable at T1 (2.13L, p=0.86), T2 (2.17L, p=0.65) and T3 (2.25L, p=0.78). In the AZA group, a statistically significant decline did not occur prior to treatment, however FVC results remained stable at T1, T2 and T3.Adverse events leading to early discontinuation (<12 months treatment) were less common in the MMF group (4/22 vs. 13/49). Gastrointestinal complications were the main cause of discontinuation in both groups.
In patients with SSc-ILD with declining pulmonary function, MMF therapy was associated with stability for up to 36 months. Early adverse events leading to discontinuation occurred less frequently in patients treated with MMF than in AZA treated patients.</description><identifier>ISSN: 0392-856X</identifier><identifier>PMID: 27049330</identifier><language>eng</language><publisher>Italy</publisher><subject>Adult ; Aged ; Australia ; Azathioprine - therapeutic use ; Databases, Factual ; Drug Therapy, Combination ; Female ; Humans ; Immunosuppressive Agents - adverse effects ; Immunosuppressive Agents - therapeutic use ; Longitudinal Studies ; Lung - drug effects ; Lung - physiopathology ; Lung Diseases, Interstitial - diagnosis ; Lung Diseases, Interstitial - drug therapy ; Lung Diseases, Interstitial - etiology ; Lung Diseases, Interstitial - physiopathology ; Male ; Middle Aged ; Mycophenolic Acid - adverse effects ; Mycophenolic Acid - therapeutic use ; Respiratory Function Tests ; Retrospective Studies ; Scleroderma, Systemic - complications ; Scleroderma, Systemic - diagnosis ; Scleroderma, Systemic - drug therapy ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Clinical and experimental rheumatology, 2016-09, Vol.34 Suppl 100 (5), p.170-176</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27049330$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Owen, Claire</creatorcontrib><creatorcontrib>Ngian, Gene-Siew</creatorcontrib><creatorcontrib>Elford, Kathleen</creatorcontrib><creatorcontrib>Moore, Owen</creatorcontrib><creatorcontrib>Stevens, Wendy</creatorcontrib><creatorcontrib>Nikpour, Mandana</creatorcontrib><creatorcontrib>Rabusa, Candice</creatorcontrib><creatorcontrib>Proudman, Susanna</creatorcontrib><creatorcontrib>Roddy, Janet</creatorcontrib><creatorcontrib>Zochling, Jane</creatorcontrib><creatorcontrib>Hill, Catherine</creatorcontrib><creatorcontrib>Sturgess, Allan</creatorcontrib><creatorcontrib>Tymms, Kathleen</creatorcontrib><creatorcontrib>Youssef, Peter</creatorcontrib><creatorcontrib>Sahhar, Joanne</creatorcontrib><title>Mycophenolate mofetil is an effective and safe option for the management of systemic sclerosis-associated interstitial lung disease: results from the Australian Scleroderma Cohort Study</title><title>Clinical and experimental rheumatology</title><addtitle>Clin Exp Rheumatol</addtitle><description>To report the efficacy and tolerability of mycophenolate mofetil (MMF) and azathioprine (AZA) in the management of systemic sclerosis-associated interstitial lung disease (SSc-ILD).
Patients in the Australian Scleroderma Cohort Study treated with at least 3 months of MMF or AZA for SSc-ILD confirmed on high resolution computed tomography (HRCT) chest were identified and their pulmonary function tests (PFTs) retrieved. Individuals with available results for T-1 (12 months prior to treatment commencement), T0 (date of treatment commencement) and at least one subsequent time point were included in the drug efficacy analysis. The Wilcoxon signed-rank test was used to compare absolute FVC at T1, T0, 12 months (T1), 24 months (T2) and 36 months (T3). Analysis of drug tolerability included all identified patients treated with MMF or AZA.
18/22 patients treated with MMF and 29/49 treated with AZA had adequate PFTs for inclusion in the drug efficacy analysis. Median absolute FVC at T1 for MMF treatment was 2.50L, declining to 2.12L at T0 (p=0.02). Following MMF therapy, FVC results were stable at T1 (2.13L, p=0.86), T2 (2.17L, p=0.65) and T3 (2.25L, p=0.78). In the AZA group, a statistically significant decline did not occur prior to treatment, however FVC results remained stable at T1, T2 and T3.Adverse events leading to early discontinuation (<12 months treatment) were less common in the MMF group (4/22 vs. 13/49). Gastrointestinal complications were the main cause of discontinuation in both groups.
In patients with SSc-ILD with declining pulmonary function, MMF therapy was associated with stability for up to 36 months. Early adverse events leading to discontinuation occurred less frequently in patients treated with MMF than in AZA treated patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Australia</subject><subject>Azathioprine - therapeutic use</subject><subject>Databases, Factual</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Humans</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Longitudinal Studies</subject><subject>Lung - drug effects</subject><subject>Lung - physiopathology</subject><subject>Lung Diseases, Interstitial - diagnosis</subject><subject>Lung Diseases, Interstitial - drug therapy</subject><subject>Lung Diseases, Interstitial - etiology</subject><subject>Lung Diseases, Interstitial - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mycophenolic Acid - adverse effects</subject><subject>Mycophenolic Acid - therapeutic use</subject><subject>Respiratory Function Tests</subject><subject>Retrospective Studies</subject><subject>Scleroderma, Systemic - complications</subject><subject>Scleroderma, Systemic - diagnosis</subject><subject>Scleroderma, Systemic - drug therapy</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>0392-856X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kM1KAzEUhWeh2Fp9BblLNwPJZDo_7krxDyouquBuSJObNpKZjLkZYR7Nt3Oo9WwuBz4-LucsmTNRZ2m1LD5mySXRJ2NZsSzKi2SWlSyvhWDz5OdlVL4_YOedjAitNxitA0sgO0BjUEX7jVPRQNIg-D5a34HxAeJh4mUn99hiF8EboJEitlYBKYfBk6VUEnllJ7UG20UMFG200oEbuj1oSygJ7yAgDS4SmODbo3c1UAzS2emJ7dGlMbQS1v7gQ4RtHPR4lZwb6QivT3eRvD_cv62f0s3r4_N6tUn7jPOYSl2Xxa7gPDecVdMgNct3RmXCKK5rXEqhlRSIpWKV1koxlXPBRFUKxfMiL8Qiuf3z9sF_DUixaS0pdE526AdqeJUVU4TIJvTmhA67FnXTB9vKMDb_c4tf2mqAaQ</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Owen, Claire</creator><creator>Ngian, Gene-Siew</creator><creator>Elford, Kathleen</creator><creator>Moore, Owen</creator><creator>Stevens, Wendy</creator><creator>Nikpour, Mandana</creator><creator>Rabusa, Candice</creator><creator>Proudman, Susanna</creator><creator>Roddy, Janet</creator><creator>Zochling, Jane</creator><creator>Hill, Catherine</creator><creator>Sturgess, Allan</creator><creator>Tymms, Kathleen</creator><creator>Youssef, Peter</creator><creator>Sahhar, Joanne</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20160901</creationdate><title>Mycophenolate mofetil is an effective and safe option for the management of systemic sclerosis-associated interstitial lung disease: results from the Australian Scleroderma Cohort Study</title><author>Owen, Claire ; Ngian, Gene-Siew ; Elford, Kathleen ; Moore, Owen ; Stevens, Wendy ; Nikpour, Mandana ; Rabusa, Candice ; Proudman, Susanna ; Roddy, Janet ; Zochling, Jane ; Hill, Catherine ; Sturgess, Allan ; Tymms, Kathleen ; Youssef, Peter ; Sahhar, Joanne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-ad976b6114f108392904bfc23fc1d9e5a3dca3ee7c08ddcc0c41303873c146463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Australia</topic><topic>Azathioprine - therapeutic use</topic><topic>Databases, Factual</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Humans</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Longitudinal Studies</topic><topic>Lung - drug effects</topic><topic>Lung - physiopathology</topic><topic>Lung Diseases, Interstitial - diagnosis</topic><topic>Lung Diseases, Interstitial - drug therapy</topic><topic>Lung Diseases, Interstitial - etiology</topic><topic>Lung Diseases, Interstitial - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mycophenolic Acid - adverse effects</topic><topic>Mycophenolic Acid - therapeutic use</topic><topic>Respiratory Function Tests</topic><topic>Retrospective Studies</topic><topic>Scleroderma, Systemic - complications</topic><topic>Scleroderma, Systemic - diagnosis</topic><topic>Scleroderma, Systemic - drug therapy</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Owen, Claire</creatorcontrib><creatorcontrib>Ngian, Gene-Siew</creatorcontrib><creatorcontrib>Elford, Kathleen</creatorcontrib><creatorcontrib>Moore, Owen</creatorcontrib><creatorcontrib>Stevens, Wendy</creatorcontrib><creatorcontrib>Nikpour, Mandana</creatorcontrib><creatorcontrib>Rabusa, Candice</creatorcontrib><creatorcontrib>Proudman, Susanna</creatorcontrib><creatorcontrib>Roddy, Janet</creatorcontrib><creatorcontrib>Zochling, Jane</creatorcontrib><creatorcontrib>Hill, Catherine</creatorcontrib><creatorcontrib>Sturgess, Allan</creatorcontrib><creatorcontrib>Tymms, Kathleen</creatorcontrib><creatorcontrib>Youssef, Peter</creatorcontrib><creatorcontrib>Sahhar, Joanne</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental rheumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Owen, Claire</au><au>Ngian, Gene-Siew</au><au>Elford, Kathleen</au><au>Moore, Owen</au><au>Stevens, Wendy</au><au>Nikpour, Mandana</au><au>Rabusa, Candice</au><au>Proudman, Susanna</au><au>Roddy, Janet</au><au>Zochling, Jane</au><au>Hill, Catherine</au><au>Sturgess, Allan</au><au>Tymms, Kathleen</au><au>Youssef, Peter</au><au>Sahhar, Joanne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mycophenolate mofetil is an effective and safe option for the management of systemic sclerosis-associated interstitial lung disease: results from the Australian Scleroderma Cohort Study</atitle><jtitle>Clinical and experimental rheumatology</jtitle><addtitle>Clin Exp Rheumatol</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>34 Suppl 100</volume><issue>5</issue><spage>170</spage><epage>176</epage><pages>170-176</pages><issn>0392-856X</issn><abstract>To report the efficacy and tolerability of mycophenolate mofetil (MMF) and azathioprine (AZA) in the management of systemic sclerosis-associated interstitial lung disease (SSc-ILD).
Patients in the Australian Scleroderma Cohort Study treated with at least 3 months of MMF or AZA for SSc-ILD confirmed on high resolution computed tomography (HRCT) chest were identified and their pulmonary function tests (PFTs) retrieved. Individuals with available results for T-1 (12 months prior to treatment commencement), T0 (date of treatment commencement) and at least one subsequent time point were included in the drug efficacy analysis. The Wilcoxon signed-rank test was used to compare absolute FVC at T1, T0, 12 months (T1), 24 months (T2) and 36 months (T3). Analysis of drug tolerability included all identified patients treated with MMF or AZA.
18/22 patients treated with MMF and 29/49 treated with AZA had adequate PFTs for inclusion in the drug efficacy analysis. Median absolute FVC at T1 for MMF treatment was 2.50L, declining to 2.12L at T0 (p=0.02). Following MMF therapy, FVC results were stable at T1 (2.13L, p=0.86), T2 (2.17L, p=0.65) and T3 (2.25L, p=0.78). In the AZA group, a statistically significant decline did not occur prior to treatment, however FVC results remained stable at T1, T2 and T3.Adverse events leading to early discontinuation (<12 months treatment) were less common in the MMF group (4/22 vs. 13/49). Gastrointestinal complications were the main cause of discontinuation in both groups.
In patients with SSc-ILD with declining pulmonary function, MMF therapy was associated with stability for up to 36 months. Early adverse events leading to discontinuation occurred less frequently in patients treated with MMF than in AZA treated patients.</abstract><cop>Italy</cop><pmid>27049330</pmid><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0392-856X |
| ispartof | Clinical and experimental rheumatology, 2016-09, Vol.34 Suppl 100 (5), p.170-176 |
| issn | 0392-856X |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Aged Australia Azathioprine - therapeutic use Databases, Factual Drug Therapy, Combination Female Humans Immunosuppressive Agents - adverse effects Immunosuppressive Agents - therapeutic use Longitudinal Studies Lung - drug effects Lung - physiopathology Lung Diseases, Interstitial - diagnosis Lung Diseases, Interstitial - drug therapy Lung Diseases, Interstitial - etiology Lung Diseases, Interstitial - physiopathology Male Middle Aged Mycophenolic Acid - adverse effects Mycophenolic Acid - therapeutic use Respiratory Function Tests Retrospective Studies Scleroderma, Systemic - complications Scleroderma, Systemic - diagnosis Scleroderma, Systemic - drug therapy Time Factors Tomography, X-Ray Computed Treatment Outcome |
| title | Mycophenolate mofetil is an effective and safe option for the management of systemic sclerosis-associated interstitial lung disease: results from the Australian Scleroderma Cohort Study |
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