Low Dose Cyclophosphamide and Prednisolone Therapy in Scleroderma Patients with Interstitial Lung Disease
Interstitial alveolitis may cause lung fibrosis, which the main cause of death in patients with scleroderma. To determine whether low dose cyclophosphamide and prednisolone is benefitial for symptomatic patients who had abnormal chest radiography compatible with scleroderma lung disease. Non-randomized control trial, before and after study was done in 30 scleroderma patients with interstial lung disease. The effect of 6 months’ treatment with cyclophosphamide 50 mg and prednisolone 5-10 mg daily on the functional capacity determine by NYHA classification and radiographic change.
Results : The treatment was well tolerated and all patients completed 6 months’ treatment. Cyclophosphamide and prednisolone improved functional capacity ; NYHA classification before treatment was 2.9 , at the end of 6th month was 1.77, p=0.05 and the 12th was 1.77. Radiographic infiltration was 100% before treatment, at the end of 6th month was 59%, p=0.05 and the 12th was 59%.
Conclusion : Low dose cyclophosphamide and prednisolone improved or stabilized symptoms and radiologic change in scleroderma patients with interstitial lung disease.
Key words : scleroderma, interstitial lung disease, cyclophosphamide, prednisolone