[FRI0313] CYCLOPHOSPHAMIDE PULSE THERAPY IN THE TREATMENT OF SYSTEMIC SCLEROSIS-INTERSTITIAL LUNG DISEASE G. Abignano, M. Iudici, A. Petrillo, G. Cuomo, G. Valentini. Rheumatology Unit, Second University of Naples, Napoli, Italy Background: Cyclophosphamide (CYC) is currently used in the treatment of interstitial lung disease (ILD) in patients with systemic sclerosis (SSc). A recent meta-analysis1 (Nannini C et al), pooling data from studies based on different entry criteria, questions its usefulness. Objectives: To investigate the effectiveness of low dose pulse CYC (500 mg/dose) in the treatment of recently deteriorating SSc-ILD. Methods: 51 patients with SSc-ILD, all of them satisfying ACR criteria for the classification of the disease and presenting with a recent (<6 months) decrease (≥10% of the predictive value) of either Forced Vital Capacity (FVC) or Diffusing Lung Capacity for CO (DLCO), were enrolled in the study. All of them underwent a concurrent prednisone therapy (10 mg/daily). CYC was administered i.v. at a dose of 500 mg weekly. Total CYC dose ranged from 4.5 to 11.5 g (median 7.5). An increase of 10% in either FVC or DLCO was considered indicative of improvement; a change between <10% and >10% of stable disease; a decrease ≥10% of worsening. Results: 22 out of the 51 SSc patients (43.14%) resulted to improve at the end of the CYC course; 17 (33.33%) remained stable; 12 (23.53%) worsened. No patients withdrew CYC treatment because of side effects. Conclusion: Our study suggests that the effectiveness of CYC in SSc-ILD may depend on entry criteria. Actually about 76% of patients who had experienced a recent deterioration of lung function, suggesting active alveolitis, underwent improvement or stabilization of their disease in our study. References:[ol][li]Nannini C, West CP, Erwin PJ, Matteson EL. Effects of cyclophosphamide on pulmonary function in patients with scleroderma and interstitial lung disease: a systematic review and meta-analysis of randomized controlled trials and observational prospective cohort studies. Arthritis Res Ther 2008, 10:R124.[/li][/ol]Disclosure of Interest: None declared Ann Rheum Dis 2009;68(Suppl3):460 Session: Scleroderma, myositis and related syndromes

Abignano, G.;Iudici, M.;Petrillo, A.;CUOMO, Giovanna;VALENTINI, Gabriele

2009