Treatment of Systemic Sclerosis with Interstitial Lung Disease in Patients Currently on Mycophenolate Mofetil

Clinical Scenario

This protocol applies to patients with systemic sclerosis who have interstitial lung disease (SSc-ILD) and are currently managed with mycophenolate mofetil (MMF). Despite MMF, further intervention may be warranted to address ongoing lung function decline.

Treatment Approach

The evidence-based approach for this scenario involves adding an antifibrotic agent to the current regimen. The full protocol specifies which agent, its dosing, and how to handle the concurrent MMF therapy — details available via the link below.

Treatment Goal

Reduction in the annual rate of decline in forced vital capacity (FVC) — the primary measure of lung function preservation in SSc-ILD.

Instant Access to Structured Evidence-Based Regimens

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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