• Kathleen Broad and Janet E Pope.
• Dalhousie University, Halifax, Nova Scotia, Canada.
• Med. Sci. Monit. 2010 Sep 1;16(9):RA187-90.

BackgroundThis meta-analysis examined all randomized controlled trials (RCTs) comparing pharmacotherapy for systemic sclerosis (SSc)-interstitial lung disease (ILD) with placebo or alternative drugs on pulmonary function tests (PFTs), quality of life, dyspnea, skin thickness, and adverse events.Material/MethodsForty studies were identified, and from these 2 RCTs examining cyclophosphamide and 1 examining bosentan met inclusion criteria (studies had to be randomized, have at least 20 SSc-ILD patients, and have PFTs as primary outcomes).ResultsDifferences between groups for change of PFT scores between baseline and 12 months were not significant when the 3 trials were combined. The treatment effect of cyclophosphamide versus placebo on forced vital capacity revealed a mean difference of 3.30% (95% confidence interval, 0.06-6.54). Diffusing capacity and total lung capacity did not change.ConclusionsThis conservative yet significant effect of cyclophosphamide demonstrates the need for further investigation of its effectiveness on patient-important outcomes such as dyspnea and quality of life, which could not be evaluated by this meta-analysis. It may be that studies in SSc-ILD need outcomes that are more sensitive to change.

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