DOES EARLY IMMUNOSUPPRESSIVE THERAPY PREVENT SYSTEMIC SCLEROSIS ASSOCIATED INTERSTITIAL LUNG DISEASE?
Abstract: OP0239 (2023)
Authors: A. Velauthapillai et al.
While recent studies reported a favorable effect on the course of interstitial lung disease (ILD) in systemic sclerosis when starting immunosuppressive (IMS) therapy in mild and moderate ILD, no definite evidence of a preventive mechanism of IMS therapy for ILD onset is established.
To assess a possible effect of preventive IMS on ILD, a combined cohort was created from the EUSTAR database and Nijmegen Systemic Sclerosis cohort, including 1037 adult SSc patients, treated with IMS (i.e. mycophenolate mofetil, methotrexate, cyclophosphamide and rituximab) and negative for signs of ILD on high-resolution CT and no prior treatment with biological or antifibrotic in the preceding years. Data between start of first IMS treatment and five years follow-up were analysed. Disease duration (time between first non-Raynaud phenomenon and start IMS) was dichotomized into early and late IMS treatment using a cut-off point of 3 years.
The incidence of ILD was 46.1% after a mean of 3.6 years of treatment and not significantly different between the groups early IMS (47%) vs. late IMS treatment (45%). There were no differences in ILD-free survival rates between the early and late treatment group.
The study did not demonstrate a role of preventive IMS therapy on ILD development, suggesting that ILD should be treated only after its manifestation in systemic sclerosis.