A Prospective Observational Study of Mycophenolate Mofetil Treatment in Progressive Diffuse Cutaneous Systemic Sclerosis of Recent Onset
The Journal of Rheumatology, 04/05/2012
Mendoza FA et al. – Patients with diffuse progressive cutaneous systemic sclerosis (SSc) of recent onset treated with mycophenolate mofetil (MMF) experienced marked improvement in skin involvement and stabilization of pulmonary function. Skin biopsies from 3 patients demonstrated histopathological improvement and decreased expression of fibrosis–related genes.
Twenty–five previously untreated consecutive patients with recent–onset (< 24 mo) diffuse progressive cutaneous SSc received MMF as the only disease–modifying therapy.
Modified Rodnan skin score (mRSS) and affected body surface area (BSA) were compared from initiation of MMF to study end.
Pulmonary function tests performed at the same institution before therapy and at study end were available in 15 patients.
Histopathology and real–time PCR assessment of fibrosis–related gene expression were performed before and after treatment in skin biopsies from 3 patients.
At 18.2 ± 8.73 months of MMF therapy (median 2000 mg/day) the mRSS decreased from 24.56 ± 8.62 to 14.52 ± 10.9 (p = 0.0004) and the affected BSA from 36% ± 16% to 14% ± 13.3% (p = 0.00001).
Pulmonary function tests remained stable from initiation of MMF to the end of the study.
Skin histopathology showed a remarkable reduction in accumulation of fibrotic tissue.
Realtime PCR of skin biopsies demonstrated a marked decrease in expression of fibrosis–related genes.
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