Treatment of Limited Cutaneous Systemic Sclerosis with Interstitial Lung Disease on Mycophenolate Mofetil
This protocol addresses a clinically specific situation: a patient with limited cutaneous systemic sclerosis (lcSSc) who has developed interstitial lung disease (SSc-ILD) and is currently being managed with mycophenolate mofetil (MMF).
Clinical Scenario
Interstitial lung disease complicating limited cutaneous systemic sclerosis, in a patient already receiving mycophenolate mofetil. The central concern is progressive loss of lung function that requires treatment escalation.
Treatment Goal
The primary objective is reduction in the annual rate of decline in forced vital capacity (FVC) — slowing the trajectory of restrictive lung impairment over time.
Treatment Approach (partial)
The protocol calls for adding nintedanib to the current regimen — dosing, route, and the decision regarding continuation of mycophenolate mofetil are defined in the full structured protocol.
Complete regimen, evidence summary, and sequencing available via the full protocol below.
References
- Nintedanib should be considered alone or in combination with MMF for the treatment of SSc-ILD.
- The relative treatment effect of nintedanib was similar (40% for those taking MMF at baseline and 46% for those not using) and consistent with that observed in the overall population (44%).
- In the primary endpoint analysis, the adjusted annual rate of change in FVC was -52.4 mL per year in the nintedanib group and -93.3 mL per year in the placebo group.
DOI: 10.1136/ard-2024-226430
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