Long-term effects of immunosuppressive therapy on lung function in scleroderma patients
The study aims to analyze the effects of induction treatment with cyclophosphamide (CYC) pulse therapy followed by maintenance treatment with other mild immunosuppressive agents on lung function in scleroderma (SSc) patients. Thirty patients with SSc (mean age 52 years, mean disease duration
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| Veröffentlicht in: | Clinical rheumatology 2018-11, Vol.37 (11), p.3043-3050 |
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| container_title | Clinical rheumatology |
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| creator | Pavlov-Dolijanovic, Slavica Vujasinovic Stupar, Nada Zugic, Vladimir Ostojic, Predrag Zekovic, Ana Zivanovic Radnic, Tatjana Jeremic, Ivan Tadic, Ivana |
| description | The study aims to analyze the effects of induction treatment with cyclophosphamide (CYC) pulse therapy followed by maintenance treatment with other mild immunosuppressive agents on lung function in scleroderma (SSc) patients. Thirty patients with SSc (mean age 52 years, mean disease duration |
| doi_str_mv | 10.1007/s10067-018-4266-0 |
| format | Article |
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Thirty patients with SSc (mean age 52 years, mean disease duration < 2 years) with forced vital capacity (FVC) ≤ 80% and/or diffusing capacity of carbon monoxide (DLco) ≤ 70% were included. Monthly CYC pulses were given for 6 months (induction treatment), followed by 3-monthly maintenance pulses for the next 18 months, and during the next 5 years patients received other mild immunosupressive therapy brought by the competent rheumatologist. The efficacy was evaluated by comparing FVC% and DLco% after 6, 24, and 84 months from the baseline. All patients completed induction and maintenance treatment with CYC. Three patients were lost to follow-up. The rest of 27 patients, during the next 5 years, received other immunosupressive agents (14 azathioprine, 9 methotrexate, and 4 mycophenolate mofetil). Three patients died in the 4 years of follow-up. By 6, 24, and 84 months, the mean FVC and DLco changes were + 0.47 and + 2.10, + 3.30 and − 2.49, and + 1.53 and − 3.76%, respectively. These changes were not significantly different from the baseline values. CYC does not appear to result in clinically significant improvement of pulmonary function but fulfilled criteria of stable disease. Maintenance treatment with other mild immunosupressive agents preserves the benefits achieved during CYC treatment.</description><identifier>ISSN: 0770-3198</identifier><identifier>EISSN: 1434-9949</identifier><identifier>DOI: 10.1007/s10067-018-4266-0</identifier><identifier>PMID: 30143960</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Adult ; Azathioprine ; Carbon monoxide ; Carbon Monoxide - blood ; Cyclophosphamide ; Cyclophosphamide - administration & dosage ; Female ; Humans ; Immunosuppressive agents ; Immunosuppressive Agents - administration & dosage ; Long-term effects ; Lung - physiopathology ; Male ; Medicine ; Medicine & Public Health ; Methotrexate ; Middle Aged ; Mycophenolate mofetil ; Mycophenolic acid ; Original Article ; Patients ; Pulse Therapy, Drug - methods ; Respiratory function ; Rheumatology ; Scleroderma ; Scleroderma, Systemic - drug therapy ; Scleroderma, Systemic - physiopathology ; Systemic sclerosis ; Time Factors ; Treatment Outcome ; Vital Capacity</subject><ispartof>Clinical rheumatology, 2018-11, Vol.37 (11), p.3043-3050</ispartof><rights>International League of Associations for Rheumatology (ILAR) 2018</rights><rights>Clinical Rheumatology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-5bcb164f989b6f545291e6868d46c05e850ab71d0381dcf95292ec2c34767f943</citedby><cites>FETCH-LOGICAL-c372t-5bcb164f989b6f545291e6868d46c05e850ab71d0381dcf95292ec2c34767f943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10067-018-4266-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10067-018-4266-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30143960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pavlov-Dolijanovic, Slavica</creatorcontrib><creatorcontrib>Vujasinovic Stupar, Nada</creatorcontrib><creatorcontrib>Zugic, Vladimir</creatorcontrib><creatorcontrib>Ostojic, Predrag</creatorcontrib><creatorcontrib>Zekovic, Ana</creatorcontrib><creatorcontrib>Zivanovic Radnic, Tatjana</creatorcontrib><creatorcontrib>Jeremic, Ivan</creatorcontrib><creatorcontrib>Tadic, Ivana</creatorcontrib><title>Long-term effects of immunosuppressive therapy on lung function in scleroderma patients</title><title>Clinical rheumatology</title><addtitle>Clin Rheumatol</addtitle><addtitle>Clin Rheumatol</addtitle><description>The study aims to analyze the effects of induction treatment with cyclophosphamide (CYC) pulse therapy followed by maintenance treatment with other mild immunosuppressive agents on lung function in scleroderma (SSc) patients. Thirty patients with SSc (mean age 52 years, mean disease duration < 2 years) with forced vital capacity (FVC) ≤ 80% and/or diffusing capacity of carbon monoxide (DLco) ≤ 70% were included. Monthly CYC pulses were given for 6 months (induction treatment), followed by 3-monthly maintenance pulses for the next 18 months, and during the next 5 years patients received other mild immunosupressive therapy brought by the competent rheumatologist. The efficacy was evaluated by comparing FVC% and DLco% after 6, 24, and 84 months from the baseline. All patients completed induction and maintenance treatment with CYC. Three patients were lost to follow-up. The rest of 27 patients, during the next 5 years, received other immunosupressive agents (14 azathioprine, 9 methotrexate, and 4 mycophenolate mofetil). Three patients died in the 4 years of follow-up. By 6, 24, and 84 months, the mean FVC and DLco changes were + 0.47 and + 2.10, + 3.30 and − 2.49, and + 1.53 and − 3.76%, respectively. These changes were not significantly different from the baseline values. CYC does not appear to result in clinically significant improvement of pulmonary function but fulfilled criteria of stable disease. Maintenance treatment with other mild immunosupressive agents preserves the benefits achieved during CYC treatment.</description><subject>Adult</subject><subject>Azathioprine</subject><subject>Carbon monoxide</subject><subject>Carbon Monoxide - blood</subject><subject>Cyclophosphamide</subject><subject>Cyclophosphamide - administration & dosage</subject><subject>Female</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Long-term effects</subject><subject>Lung - physiopathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methotrexate</subject><subject>Middle Aged</subject><subject>Mycophenolate mofetil</subject><subject>Mycophenolic acid</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pulse Therapy, Drug - methods</subject><subject>Respiratory function</subject><subject>Rheumatology</subject><subject>Scleroderma</subject><subject>Scleroderma, Systemic - drug therapy</subject><subject>Scleroderma, Systemic - physiopathology</subject><subject>Systemic sclerosis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vital Capacity</subject><issn>0770-3198</issn><issn>1434-9949</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kEuLFTEQRoMoznX0B7iRgBs30cqj81jK4AsuuFFchu505dpDd9Im3cL8e3O5o4LgJkWoU18Vh5DnHF5zAPOmtlcbBtwyJbRm8IAcuJKKOafcQ3IAY4BJ7uwVeVLrLQAI6_hjciWhYU7DgXw75nRiG5aFYowYtkpzpNOy7CnXfV0L1jr9RLp9x9KvdzQnOu_pROOewja135RoDTOWPLaMnq79NmHa6lPyKPZzxWf39Zp8ff_uy81Hdvz84dPN2yML0oiNdUMYuFbRWTfo2KlOOI7aajsqHaBD20E_GD6CtHwM0bW-wCCCVEab6JS8Jq8uuWvJP3asm1-mGnCe-4R5r16AkwrAStHQl_-gt3kvqV13poRpBpVsFL9QoeRaC0a_lmnpy53n4M_W_cW6b9b92bqHNvPiPnkfFhz_TPzW3ABxAWprpROWv6v_n_oL58OMeg</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Pavlov-Dolijanovic, Slavica</creator><creator>Vujasinovic Stupar, Nada</creator><creator>Zugic, Vladimir</creator><creator>Ostojic, Predrag</creator><creator>Zekovic, Ana</creator><creator>Zivanovic Radnic, Tatjana</creator><creator>Jeremic, Ivan</creator><creator>Tadic, Ivana</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20181101</creationdate><title>Long-term effects of immunosuppressive therapy on lung function in scleroderma patients</title><author>Pavlov-Dolijanovic, Slavica ; 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Thirty patients with SSc (mean age 52 years, mean disease duration < 2 years) with forced vital capacity (FVC) ≤ 80% and/or diffusing capacity of carbon monoxide (DLco) ≤ 70% were included. Monthly CYC pulses were given for 6 months (induction treatment), followed by 3-monthly maintenance pulses for the next 18 months, and during the next 5 years patients received other mild immunosupressive therapy brought by the competent rheumatologist. The efficacy was evaluated by comparing FVC% and DLco% after 6, 24, and 84 months from the baseline. All patients completed induction and maintenance treatment with CYC. Three patients were lost to follow-up. The rest of 27 patients, during the next 5 years, received other immunosupressive agents (14 azathioprine, 9 methotrexate, and 4 mycophenolate mofetil). Three patients died in the 4 years of follow-up. By 6, 24, and 84 months, the mean FVC and DLco changes were + 0.47 and + 2.10, + 3.30 and − 2.49, and + 1.53 and − 3.76%, respectively. These changes were not significantly different from the baseline values. CYC does not appear to result in clinically significant improvement of pulmonary function but fulfilled criteria of stable disease. Maintenance treatment with other mild immunosupressive agents preserves the benefits achieved during CYC treatment.</abstract><cop>London</cop><pub>Springer London</pub><pmid>30143960</pmid><doi>10.1007/s10067-018-4266-0</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Azathioprine Carbon monoxide Carbon Monoxide - blood Cyclophosphamide Cyclophosphamide - administration & dosage Female Humans Immunosuppressive agents Immunosuppressive Agents - administration & dosage Long-term effects Lung - physiopathology Male Medicine Medicine & Public Health Methotrexate Middle Aged Mycophenolate mofetil Mycophenolic acid Original Article Patients Pulse Therapy, Drug - methods Respiratory function Rheumatology Scleroderma Scleroderma, Systemic - drug therapy Scleroderma, Systemic - physiopathology Systemic sclerosis Time Factors Treatment Outcome Vital Capacity |
| title | Long-term effects of immunosuppressive therapy on lung function in scleroderma patients |
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