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High-dose prednisolone and bolus cyclophosphamide in interstitial lung disease associated with systemic sclerosis: A prospective open study
International Journal of Rheumatic Diseases, 08/19/09
Wanchu A et al. – Study shows that high-dose prednisolone with pulse cyclophosphamide (CYC) can either improve or stabilize lung functions in patients with severe systemic sclerosis (SSc) lung disease irrespective of presence of ground glass appearance on high-resolution computed tomography (HRCT).
Methods- A study in North Indian tertiary institute to assess the efficacy of intermittent pulse CYC and high-dose prednisolone in SSc-related interstitial lung disease (ILD)
- Consecutive pts with SSc and ILD, diagnosed on spirometry, carbon monoxide diffusing capacity (DLCO) and (HRCT) scan were treated
- Pulmonary function tests were carried out at baseline and after 6 mo
- Pts received oral prednisolone 1 mg/kg body weight initially, with tapering to a dose of 7.5 mg/d
- Monthly CYC pulses were given for 6 mo followed by 3-monthly maintenance pulses
- CYC was discontinued in pts with declining pulmonary function, adverse effects or static disease after 6 mo
- Average disease duration of 36 pts was 59.78 ± 63.22 mo
- 7 pts improved, 5 deteriorated, and 24 had stable disease
- Thus, 31 of 36 pts either improved or had static lung disease
- Mean FVC improved by 4.16% over 6 mo
- Mean DLCO improved by 5.66%
- Average % of predicted DLCO at baseline was 39%
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