'Easily available medicines effective in treating Scleroderma'

Two easily available medicines can effectively treat scleroderma interstitial lung disease, a study conducted by an Indian doctor has found.
The research by Kochi-based doctor Padmanabha D Shenoy says data is there to suggest Cyclophosphamide (CYC) and Mycophenolate Mofetil (MMF) are effective in management of scleroderma interstitial lung disease (SSc-ILD).
The study, published in the latest issue of international medical journal 'Arthritis Research and Therapy' is expected to give relief to lakhs of people who suffer from Scleroderma-- a systemic autoimmune disease characterised mainly by skin manifestations and involvement of various visceral organs, especially the lungs, Shenoy said here.
"Approximately 80 per cent of patients have evidence of pulmonary fibrosis at post-mortem examination or on high esolution computed tomography, although clinically evident disease is present only in approximately 40 per cent of patients," it said.

The research said that for over 15 years, cyclophosphamide (CYC) has been used in treating SSc-ILD.
"CYC is a cytotoxic immunosuppressive agent that suppresses lymphokine production and modulates lymphocyte function by alkylating various cellular constituents and depressing the inflammatory response via normalisation of neutrophilia and healing of vascular endothelial cells.

"CYC is the only agent shown to at least stabilise lung function in a randomized, controlled trial," it said.
According to the research, Mycophenolic acid has emerged recently as a promising therapy for SSc.
"Evidence supporting its use derives from small, uncontrolled, single-arm studies, suggesting that mycophenolate is a safe therapeutic modality associated with functional stabilisation of SSc-ILD," the paper said.

"We support the use of immunosuppressants in patients with scleroderma ILD. Although MMF and CYC may be equally effective, MMF may be preferred due to the long-term toxicity of CYC. Larger randomized controlled studies are sorely needed to support this premise," it concludes.