Mycophenolate mofetil is safe, well tolerated, and preserves lung function, in patients with connective tissue disease-related interstitial lung disease
Mycophenolate mofetil is safe, well tolerated, and preserves lung function, in patients with connective tissue disease-related interstitial lung disease
复制标题
DOI：
10.1016/s0012-3692(15)50949-5
复制
发表时间：
2006-07-01
期刊：
影响因子：
9.6
通讯作者：
Brown, Kevin K.
中科院分区：
文献类型：
--
作者：
Swigris, Jeffrey J.;Olson, Amy L.;Brown, Kevin K.
背景：间质性肺病(ILD)常合并结缔组织病(CTD)。糖皮质激素和免疫调节剂被认为是治疗CTD相关性ILD的主要药物；然而，除了评估某些药物治疗硬皮病患者的研究外，很少有研究进行。在这项研究中，我们的目标是检查霉酚酸酯的安全性和耐受性。(MMF)，并确定其对CTD-ILD患者肺功能的影响。方法：在这项回顾性观察研究中，我们分析了我们中心接受MMF治疗CTD-ILD的患者。我们检查了与MMF相关的副作用的频率和严重程度，并使用纵向数据分析方法来确定MMF在一段时间内维持肺功能的能力。结果：28名患者接受MMF治疗超过35.9个病历年。最常见的CTD诊断是硬皮病(n=9)。启动MMF的最常见原因是先前免疫调节剂的不良反应。6名患者有与MMF相关的临床显著副作用；均通过减少剂量得以缓解。与MMF治疗前相比，患者在接受MMF治疗期间的平均每日泼尼松剂量减少(10 mg/d对15 mg/d，p=0.09)。此外，使用MMF后，队列患者预计用力肺活量(FVC)的平均百分比、预计总肺活量的平均百分比和肺一氧化碳弥散量的平均百分比分别增加了2.3%、4.0%和2.6%。结论：MMF在CTD-ILD患者中是安全和耐受的。需要更大规模的研究来进一步评估MMF在这一患者群体中的疗效。
Background: Interstitial lung disease (ILD) frequently complicates connective tissue diseases (CTDs). Glucocorticoids and immunomodulatory agents are regarded as mainstays of therapy for CTD-related ILD; however, apart from those studies that have evaluated certain medications for patients with scleroderma, few studies have been performed. In this study, our objectives were to examine the safety and tolerability of mycophenolate mofetil. (MMF) and to determine its impact on lung function in patients with CTD-ILD.Methods: In this retrospective observational study, we analyzed patients at our center who ever received MMF for CTD-ILD. We examined the frequency and severity of side effects associated with MMF and used longitudinal data analytic methods to determine the ability of MMF to maintain lung function over time.Results: Twenty-eight patients were treated with MMF over 35.9 patient-years. The most common underlying CTD diagnosis was scleroderma (n = 9). The most common reason for initiating MMF was an adverse effect of a prior immunomodulatory agent. Six patients had clinically significant side effects related to MMF; all resolved with dose reduction. Compared to before MMF, the mean daily prednisone dose while patients were receiving MMF was lower (10 mg/d vs 15 mg/d, p = 0.09). In addition, since starting MMF, the average percentage of predicted forced vital capacity (FVC), average percentage of predicted total lung capacity, and average percentage of predicted diffusing capacity of the lung for carbon monoxide for the cohort increased by 2.3%, 4.0%, and 2.6%, respectivelyConclusion: MMF appears to be safe and well tolerated in patients with CTD-ILD. Larger-scale studies are needed to further evaluate the efficacy of MMF in this patient population.