Mycophenolate mofetil is an effective therapy for connective tissue disease-associated interstitial lung disease

Author(s): Mohammed A Omair & Esam H Alhamad

Introduction: Mycophenolate mofetil (MMF) is increasingly used in the management of connective tissue disease-related interstitial lung disease (CTD-ILD). The aim of this study was to evaluate the safety and efficacy of MMF in patients with CTD-ILD based on the ILD subtype regardless of the underlying CTD. Method: This was a retrospective single-center study. Patients with ILD-CTD who had either non-specific interstitial pneumonia (NSIP) or usual interstitial pneumonia (UIP) who received MMF therapy were included. Patients who received cyclophosphamide (CYC) or rituximab (RTX) were excluded. A 5% change in the forced vital capacity (FVC) and diffusion capacity of carbon monoxide (DLco) and a 30-meter change in the 6-min walk test (6MWT) were considered significant. Results: Forty patients were included. There was a female predominance (67.5%), with a mean (± standard deviation) age and disease duration of 54.1 ± 15.8 years and 61.4 ± 75.5 months, respectively. The mean ILD duration was 43.2 ± 27.7 months. The mean FVC and DLco were 54.6 ± 16.0% and 59.4 ± 14.2%, respectively. There were 22 (55%) and 18 (45%) patients in the CTD-NSIP and CTD-UIP groups, respectively. All patients achieved a target dose of 2-3 g/day. Treatment with MMF resulted in stabilization and/or improvement of FVC in 28 (70%) patient, of DLco in 24/33 (72.7%) patients, and of 6MWT in 23/37 (62.1%) patients. The response to MMF was identical in both ILD subtypes, with all measures achieving a statistical significance. No safety signals were detected. Conclusion: MMF is safe and effective in the management of CTD-ILD regardless of the underlying ILD subtype.

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