| Contributors: |
De Lorenzis, Enrico; Natalello, Gerlando; De Angelis, Rossella; Verardi, Lucrezia; Giuggioli, Dilia; Bajocchi, Gianluigi; Dagna, Lorenzo; Bellando-Randone, Silvia; Zanframundo, Giovanni; Foti, Rosario; Cacciapaglia, Fabio; Cuomo, Giovanna; Ariani, Alarico; Rosato, Edoardo; Lepri, Gemma; Girelli, Francesco; Riccieri, Valeria; Zanatta, Elisabetta; Cavazzana, Ilaria; Ingegnoli, Francesca; De Santis, Maria; Murdaca, Giuseppe; Abignano, Giuseppina; Pettiti, Giorgio; Della Rossa, Alessandra; Caminiti, Maurizio; Iuliano, Annamaria; Ciano, Giovanni; Beretta, Lorenzo; Bagnato, Gianluca; Lubrano, Ennio; Ilenia De Andres, Maria; Giollo, Alessandro; Bruni, Cosimo; Orlandi, Martina; Fornaro, Marco; Saracco, Marta; Agnes, Cecilia; Giacomo Cerasuolo, Pier; Alonzi, Gabriella; Cipolletta, Edoardo; Lumetti, Federica; Spinella, Amelia; Magnani, Luca; Campochiaro, Corrado; De Luca, Giacomo; Codullo, Veronica; Visalli, Elisa; Iandoli Antonietta Gigante, Carlo; Pellegrino, Greta; Pigatto, Erika; Lazzaroni, Maria-Grazia; Franceschini, Franco; Generali, Elena; Mennillo, Gianna; Barsotti, Simone; Pagano Mariano, Giuseppa; Furini, Federica; Vultaggio, Licia; Parisi, Simone; Lisa Peroni, Clara; Bianchi, Gerolamo; Fusaro, Enrico; Domenico Sebastiani, Gian; Govoni, Marcello; D'Angelo, Salvatore; Cozzi, Franco; Conti, Fabrizio; Guiducci, Serena; Doria, Andrea; Salvarani, Carlo; Iannone, Florenzo; Antonietta D’Agostino, Maria; Ferri, Clodoveo; Matucci Cerinic, Marco; Laura Bosello, Silvia |
| Description: |
Objective Mycophenolate Mofetil (MMF) use in limited cutaneous systemic sclerosis (lcSSc) is relatively uncommon due to the lower fibrotic burden and the predominance of the vascular complications. In vitro observations and clinical data from transplanted patients suggest a protective effect of MMF on endothelial function. Our aim was to evaluate the reasons for prescribing MMF treatment in patients with lcSSc and its impact on the need for escalation of vascular complication–related treatments during follow-up. Methods LcSSc patients enrolled in the Italian SPRING registry were retrospectively evaluated. All patients treated with MMF were matched to patients not treated with MMF, based on a roll-entry time-dependent propensity score built on demographics, clinical features and baseline treatment. The escalation of vasoactive or vasodilator treatment up to 60 months was defined as the introduction of iloprost, endothelin receptor antagonists, or phosphodiesterase-5 inhibitors on top of the ongoing treatment, due to uncontrolled or newly diagnosed vascular complications. A hazards Cox model was also adopted to quantify the association of MMF treatment with treatment escalation. Results A total of 1,435 lcSSc patients were evaluated, of whom 152 were prescribed MMF (17.1% male; mean age at lcSSc onset 48.7±13.9 years, 54.6% anti-Scl70 positive). The prescription of MMF was more common in 21514658, ja, Downloaded from https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr.70039 by Dilia Giuggioli - University Modena , Wiley Online Library on [16/01/2026]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License Mycophenolate mofetil and vascular complications of systemic sclerosis males and in anti-Scl70 positive patients, anti-centromere negative, and in patients with interstitial lung disease, myositis, and without a history of digital ulcers. After matching 107 patients ... |