Finally, the authors call for studies to compare cyclophosphamide with anti-fibrotic agents or to compare both with placebo, especially in patients with evidence of rapidly progressive fibrotic disease. These studies should aim to determine the optimal treatment duration for induction therapies, as well as the optimal combination and duration of maintenance therapies. The authors suggest that because connective tissue disease-associated ILD is rare, national registries may help researchers identify patients with rare lung diseases who would be eligible for such a clinical trial.
Lara C. Pullen, PhD, is a medical writer based in the Chicago area.
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Fast Facts
- A Cochrane review found no clear evidence that patients treated with cyclophosphamide had better lung function than patients treated with mycophenolate mofetil.
- The authors of the systematic review cautioned that physicians should expect treatment with cyclophosphamide to result only in a modest improvement in the preservation of forced vital capacity.
- Patients treated with cyclophosphamide should be monitored for adverse effects during treatment, as well as in the years following treatment.
References
- Barnes H, Holland AE, Westall GP, et al. Cyclophosphamide for connective tissue disease-associated interstitial lung disease. Cochrane Database Syst Rev. 2018 Jan 3;1:CD010908.
- Tashkin DP, Roth MD, Clements PJ, et al. Mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II): a randomised controlled, double-blind, parallel group trial. Lancet Respir Med. 2016 Sep;4(9):708–719. Epub 2016 Jul 25.
