Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis-Reference-Cited by-同舟云学术

Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis

Published:2023-01-01 Issue:1 Volume:18 Page:
ISSN:2391-5463
Container-title:Open Medicine
language:en
Short-container-title:

Author:

Wang Pengfei¹^ORCID,Zhang Li²^ORCID,Guo Qian¹^ORCID,Zhao Lifen³^ORCID,Hao Yanyan³^ORCID

Affiliation:

1. Department of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University , Taiyuan , Shanxi, 030032 , China

2. Department of Respiratory, Shanxi Provincial Hospital of Traditional Chinese Medicine , Taiyuan , 030012 , China

3. Department of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University , No.99 of Longcheng Street, Xiaodian District, , Taiyuan , Shanxi, 030032 , China

Abstract

Abstract The decision for definitive therapy for the treatment of patients with connective tissue disease-associated interstitial lung disease (CTD-ILD) is difficult. Patients with CTD-ILD received 0.5 g twice a day of mycophenolate mofetil for 2 years (MMF cohort, n = 105) or cyclophosphamide 50 mg once every other day, and the cumulative dose of cyclophosphamide should not exceed 10 g (CYC cohort, n = 140). After complete of treatment (EL), % forced vital capacity (FVC) and % diffusing capacity of the lungs for carbon monoxide were increased in both the MMF and CYC cohorts as compared to before treatment (p < 0.001 for all). There were higher changes in % FVC values and a greater number of patients with significant change in % FVC (>10% change) in the CYC cohort than in the MMF cohort (p < 0.0001 for both) at EL. Patients in the CYC cohort had higher rates of leukopenia, thrombocytopenia, serious adverse effects related to treatment(s), and death than those in the MMF cohort (p < 0.05 for all). Cyclophosphamide plus prednisolone superiorly improved % FVC compared to mycophenolate mofetil plus prednisolone. Mycophenolate mofetil and cyclophosphamide improved pulmonary function. Mycophenolate mofetil is less toxic and increased patient survival.

Publisher

Walter de Gruyter GmbH

Subject

General Medicine

Link

https://www.degruyter.com/document/doi/10.1515/med-2023-0838/pdf

Reference19 articles.

1. Antoniou KM, Margaritopoulos GA, Tomassetti S, Bonella F, Costabel U, Poletti V. Interstitial lung disease. Eur Respir Rev. 2014;23(131):40–54. 10.1183/09059180.00009113.

2. Barnes H, Holland AE, Westall GP, Goh NS, Glaspole IN. Cyclophosphamide for connective tissue disease-associated interstitial lung disease. Cochrane Database Syst Rev. 2018;1(1):CD010908. 10.1002/14651858.CD010908.pub2.

3. Ahlmann M, Hempel G. The effect of cyclophosphamide on the immune system: implications for clinical cancer therapy. Cancer Chemother Pharmacol. 2016;78(4):661–71. 10.1007/s00280-016-3152-1.

4. Furst DE, Tseng CH, Clements PJ, Strange C, Tashkin DP, Roth MD, et al. Adverse events during the scleroderma lung study. Am J Med. 2011;4(5):459–67. 10.1016/j.amjmed.2010.12.009.

5. Tashkin DP, Roth MD, Clements PJ, Furst DE, Khanna D, Kleerup EC, et al. Mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II): A randomised controlled, double-blind, parallel group trial. Lancet Respir Med. 2016;4(9):708–19. 10.1016/S2213-2600(16)30152-7.