Mycophenolate Mofetil (MMF) In Various Interstitial Lung Diseases (ILD)

Fischer, Aryeh; Krishnamoorthy, Mahalakshmi; Olson, Amy L.; Solomon, Joshua J.; Pérez, Evans R. Fernández; Huie, Tristan J.; Frankel, Stephen K.; Cosgrove, Gregory P.; Meehan, Richard T.; Bois, Roland M. du; Brown, Kevin K.; Swigris, Jeffrey J.

doi:10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a3638

Cited by 4 publications

(4 citation statements)

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“…ILD early diagnosis and effective treatment are crucial in the management of CTD because lung involvement is burdened by a high degree of morbidity and mortality [22]. Mycophenolate mofetil, azathioprine, cyclosporine and tacrolimus are all reasonable options in CTD-ILD [75][76][77][78][79][80]; generally, CYC is considered the treatment of choice for more aggressive and evolutive forms of ILD being associated with stabilization of FVC, although its impact on DLCO is less remarkable [81,82]. This outlines the need for novel therapeutic options, particularly for patients with more severe lung involvement.…”

Section: Discussionmentioning

confidence: 99%

Targeting CD20 in the treatment of interstitial lung diseases related to connective tissue diseases: A systematic review

Bellan

Patrucco

Barone-Adesi

et al. 2020

Autoimmunity Reviews

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Section: Discussionmentioning

confidence: 99%

Targeting CD20 in the treatment of interstitial lung diseases related to connective tissue diseases: A systematic review

Bellan

Patrucco

Barone-Adesi

et al. 2020

Autoimmunity Reviews

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“…Immunosuppressive regimen with azathioprine (AZA) or mycophenolate mofetil (MMF) should be considered for patients as a glucocorticoid sparing therapy to prevent developing side effects to it. Both AZA and MMF have been shown to stabilize FVC decline in patients with CTD-ILDs (these cohorts had patients with SS-ILD as well) [79,242]. In a recently published retrospective study, patients with pSS-ILD (19 cases) had a modest FVC% and DLco% slope improvement over time with use of both AZA and more favorably MMF, revealing the efficacy of both immune modulators on this condition [243].…”

Section: Treatment Of Interstitial Lung Diseasementioning

confidence: 99%

Perspective Chapter: Pulmonary System and Sjogren’s Syndrome

Ehtesham¹,

Tiwari²,

George³

et al. 2022

Idiopathic Pulmonary Fibrosis

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Sjogren’s syndrome (SS) is a connective tissue disease targeting the exocrine glands with subsequent sicca symptoms mainly in eyes and mouth. Respiratory symptoms may be the most frequent extraglandular manifestation following fatigue and pain. Mucosal dysfunction may affect the upper and lower airways, being the small airways more frequently involved. Parenchymal disease carries most of the morbidity and mortality. Nonspecific interstitial pneumonia (NSIP) is the most common radiographic feature, whereas the fibrotic NSIP type is the most reported finding in biopsies. Pulmonary lymphoma may arise from bronchial-associated lymphoid tissue lesions, and although rare, it is prevalent in SS. Chronic hypertrophic bronchial wall changes may ascribe to the various cystic lesions. Under their presence, possible lymphocytic interstitial pneumonia, amyloidosis, and lymphoma should be explored. Pulmonary arterial hypertension may present as frequently as in lupus, especially in Asian populations. Advanced knowledge in the pathogenesis has helped in understanding the various presentations within the respiratory system, contrasting with the scarce therapeutic options to treat both the airway and parenchymal disease. Anti-fibrotic parenchymal lung therapy offers promising outcomes. The pulmonary involvement in SS may associate with a decline in quality of life and reduced life expectancy. Subsequently, clinicians should know these facts for a timely intervention.

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“…MMF combined with a low dose of prednisone showed an improvement in lung functional parameters (FVC and DLCO) in the subgroup of patients with an RA-associated non-UIP pattern, and a stabilization of these parameters in patients with the UIP pattern. Moreover, MMF proved to be well tolerated by patients with a median of treatment of 897 days and with a discontinuation rate due to adverse events of less than 10% [54]. The mean age in the enrolled subjects was 60.4 ± 11.6 year (mean ± SD); however, no specific analysis was performed to address the impact of age on the efficacy and safety of MMF.…”

Section: Treatment Of Ra-ild According To Agementioning

confidence: 99%

Interstitial Lung Disease in Elderly Rheumatoid Arthritis Patients

et al. 2019

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The increase in life expectancy together with better care of rheumatoid arthritis (RA) has led to higher proportions of elderly individuals with RA. This has challenged the treatment of the disease in older ages, usually characterized by comorbid conditions and polypharmacy. Overall, the lung involvement in RA is present in up to 80% of patients subjects, depending on the assessment tools used, and mainly with features of interstitial abnormalities are among the most common: when present, interstitial lung disease (ILD) worsens the prognosis of RA, being the second most common cause of mortality. The aged lung undergoes functional and structural changes termed immunosenescence and inflammaging, which facilitate the occurrence of fibrosis of the lung.Therefore, ILD tends to occur more frequently in older patients with RA. The age at onset of RA distinguishes subjects patients in young-onset RA (YORA, <60 yrs) and late-onset RA (LORA, >60 yrs); the latter are characterized by more severe features of the disease and higher rates of lung involvement. The most frequent RA-related ILD radiological pattern is the usual interstitial pneumonia (UIP); this includes peripheral and basal predominant reticulation and honeycombing with or without associated traction bronchiectasis. Subjects Patients with the UIP pattern are usually older and with more rapid decline in lung function and worse prognosis. Treatment with corticosteroids in elderly patients carries the risk of adverse effects, such as osteoporosis, infections, diabetes, peptic ulcers, and cataract. The use of disease-modifying antirheumatic drugs (DMARDs) is well-tolerated by the elderly. The current narrative review aims at elucidating the association between ILD and RA in older individuals.

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Mycophenolate Mofetil (MMF) In Various Interstitial Lung Diseases (ILD)

Cited by 4 publications

References 0 publications

Targeting CD20 in the treatment of interstitial lung diseases related to connective tissue diseases: A systematic review

Targeting CD20 in the treatment of interstitial lung diseases related to connective tissue diseases: A systematic review

Perspective Chapter: Pulmonary System and Sjogren’s Syndrome

Interstitial Lung Disease in Elderly Rheumatoid Arthritis Patients

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