Immunosuppression for interstitial lung disease in systemic sclerosis

Eur Respir Rev. 2013 Sep 1;22(129):236-43. doi: 10.1183/09059180.00001813.

Abstract

The efficacy of immunosuppressors in the treatment of systemic sclerosis-interstitial lung disease is still matter of controversy. In this review we will analyse the evidence that immunosuppressors, despite not being able to reverse fibrotic changes, may help in slowing disease progression. Induction treatment with cyclophosphamide should be started as soon as possible in patients at risk for progression. Mycophenolate mofetil and rituximab have to be considered in patients who are unable to tolerate cyclophosphamide. After remission, maintenance treatment with mycophenolate mofetil or azathioprine should be started in order to preserve the benefits achieved during the induction treatment.

Publication types

  • Review

MeSH terms

  • Disease Progression
  • Drug Administration Schedule
  • Drug Substitution
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / etiology
  • Recurrence
  • Remission Induction
  • Scleroderma, Systemic / complications*
  • Treatment Outcome

Substances

  • Immunosuppressive Agents