Eficacia del micofenolato asociado a metotrexato como tratamiento de mantenimiento de la enfermedad pulmonar intersticial asociada a la esclerosis sistémica

Gonzalez-Nieto, Jose Antonio; Martin-Suarez, Ignacio Javier; Gil-Muñoz, Francisco

doi:10.1016/j.arbres.2011.06.007

Cited by 3 publications

(4 citation statements)

References 4 publications

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“…Mycophenolate was used as a first line agent in 3 studies[ 20 , 28 , 39 ]. Mycophenolate compounds were used for induction (n = 13 studies[ 20 – 22 , 24 , 26 – 29 , 34 , 37 , 39 – 41 ]), for maintenance (n = 18 studies[ 19 – 22 , 24 – 29 , 33 , 34 , 37 – 42 ]), for both induction and maintenance (n = 14 studies[ 20 – 22 , 24 – 29 , 34 , 36 , 37 , 39 , 41 ]), and as rescue therapy (n = 2 studies[ 30 , 43 ]). Herrick et al[ 23 ] reported a prospective observational study which assessed 5 immunosuppressive regimens: intravenous cyclophosphamide followed by mycophenolate mofetil; anti-thymocyte globulin (ATG) followed by mycophenolate mofetil; mycophenolate mofetil alone; and other immunosuppressant treatment; and no disease-modifying treatment.…”

Section: Resultsmentioning

confidence: 99%

“…Herrick et al[ 23 ] reported a prospective observational study which assessed 5 immunosuppressive regimens: intravenous cyclophosphamide followed by mycophenolate mofetil; anti-thymocyte globulin (ATG) followed by mycophenolate mofetil; mycophenolate mofetil alone; and other immunosuppressant treatment; and no disease-modifying treatment. Other induction regimens were ATG and glucocorticosteroids combination[ 19 ], and cyclophosphamide[ 30 , 33 , 43 ]. Prior immunosuppression was reported in 12 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Prior immunosuppression was reported in 12 studies. [ 22 – 27 , 30 , 31 , 33 , 36 , 37 , 43 ] Concomitant glucocorticosteroids were used in 11 studies[ 19 , 21 – 25 , 29 , 37 – 39 , 41 ]. Treatment of skin disease and lung involvement were the only 2 indications.…”

Section: Resultsmentioning

confidence: 99%

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Safety and Effectiveness of Mycophenolate in Systemic Sclerosis. A Systematic Review

2015

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BackgroundMycophenolate is increasingly being used in the rheumatic diseases. Its main adverse effects are gastrointestinal, myelosuppression, and infection. These may limit use in systemic sclerosis (SSc) since gastrointestinal involvement is common. The objective of this study is to evaluate gastrointestinal adverse events of mycophenolate in SSc. Secondarily we evaluated other adverse events, and the effectiveness of mycophenolate in skin and lung disease.MethodsA literature search of Medline, Embase, Cochrane Central Register of Controlled Trials, and CINAHL (inception-2013) was performed. Studies reporting use of mycophenolate in SSc patients, adverse events, modified Rodnan skin score (MRSS), forced vital capacity (FVC), or diffusing capacity of carbon monoxide (DLCO) were included. The primary outcome was gastrointestinal events occurring after the initiation of mycophenolate. Secondary safety outcomes included myelosuppression, infection, malignancy, and death after the initiation of mycophenolate.Results617 citations were identified and 21 studies were included. 487 patients were exposed to mycophenolate. The mean disease duration ranged between 0.8-14.1 years. There were 18 deaths and 90 non-lethal adverse events. The non-lethal adverse events included 43 (47.7%) gastrointestinal events, 34 (26%) infections, 6 (5%) cytopenias and 2 (2%) malignancies. The most common gastrointestinal events included diarrhea (n=18 (14%)), nausea (n=12 (9%)), and abdominal pain (n=3 (2%)). The rate of discontinuation ranged between 8%-40%. Seven observational studies reported improvement or stabilization in FVC, and 5 studies report stabilization or improvement in MRSS.ConclusionMycophenolate-associated gastrointestinal adverse events are common in SSc, but not severe enough to preclude its use. Observational data suggests mycophenolate may be effective in improving or stabilizing interstitial lung disease, and skin involvement.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Safety and Effectiveness of Mycophenolate in Systemic Sclerosis. A Systematic Review

2015

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“…Although some aspects of the etiopathogenesis remain unknown, significant progress has been made over the past years that has led to increased survival rates and targeted treatment for the use of new molecules in the pathogenic chain of SSc (1). In recent decades, SSc and other autoimmune diseases and neoplasms have been the focus of numerous studies that have made important contributions to the therapeutic approach (36)(37)(38). The aim of future studies is to reveal new facets of the etiopathogenesis of the disease in order to profile future effective therapies for this collagenosis (2), thereby benefitting patients.…”

Section: Discussionmentioning

confidence: 99%

Old and new therapeutic strategies in systemic sclerosis (Review)

et al. 2021

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Systemic sclerosis (SSc) is a chronic inflammatory disease with autoimmune determinism having an incompletely known pathogenesis. Although not all links in the pathogenic chain are known, studies have shown that vasculopathy is the initial event and is followed by extensive fibrosis of the skin and internal organs. New therapeutic strategies have been developed in recent years, thanks to innovative research which has increased understanding of the disease mechanisms. No curative treatment for SSc is currently known. Therefore, the therapeutic target in SSc is its symptomatology. Peripheral vasculopathy can be improved by administering vasodilators. Endothelin receptor antagonists and 5-phosphodiesterase inhibitors have a double benefit, both on peripheral and on pulmonary vasculopathy. Several molecules with antifibrotic effects are currently available; however, further studies are needed to confirm their beneficial effects. Immunosuppressants manage to control the cutaneous and visceral fibrotic process, thereby remaining as first-line drugs in the treatment of SSc. Although biological therapy using rituximab and tocilizumab has shown promising results in pulmonary fibrosis, ongoing studies are needed to determine their exact impact. The authors have differing views on the triggering role of glucocorticoids and the benefits of angiotensin-converting enzyme inhibitors in renal scleroderma. Some aspects of this disease such as calcinosis and pruritus, asthenia, or joint and muscle damage, remain difficult to manage. Contents 1. Introduction 2. Immunosuppressive therapy 3. Treatment of digital microvasculopathy 4. Treatment of pulmonary hypertension 5. Treatment of skin fibrosis 6. Treatment of pulmonary fibrosis 7. Treatment of sclerodermal renal crisis 8. Treatment of esogastrointestinal damage 9. Conclusions

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miRNA-133 and lncRNA-H19 expressions and their relation to serum levels of PKM2 and TGF-β in patients with systemic sclerosis

Khedr,

Shaker,

EL-Komy

et al. 2024

Non-coding RNA Research

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Eficacia del micofenolato asociado a metotrexato como tratamiento de mantenimiento de la enfermedad pulmonar intersticial asociada a la esclerosis sistémica

Cited by 3 publications

References 4 publications

Safety and Effectiveness of Mycophenolate in Systemic Sclerosis. A Systematic Review

Safety and Effectiveness of Mycophenolate in Systemic Sclerosis. A Systematic Review

Old and new therapeutic strategies in systemic sclerosis (Review)

miRNA-133 and lncRNA-H19 expressions and their relation to serum levels of PKM2 and TGF-β in patients with systemic sclerosis

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