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Related Experiment Videos

Advances in immunosuppressive therapy.

Wendy Marder1, W Joseph McCune

  • 1Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-0358, USA.

Seminars in Respiratory and Critical Care Medicine
|September 4, 2007
PubMed
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Traditional immunosuppressive drugs are key treatments for rheumatic lung diseases. This review covers their use, including sequential therapies and new regimens for severe vasculitis and scleroderma-related lung fibrosis.

Area of Science:

  • Rheumatology
  • Pulmonology
  • Pharmacology

Background:

  • Traditional immunosuppressive drugs are mainstays for rheumatic lung diseases, despite interest in biologics.
  • Review covers cyclophosphamide, chlorambucil, azathioprine, methotrexate, leflunomide, cyclosporine, and mycophenolate mofetil.

Purpose of the Study:

  • To review the mechanism of action, administration, and clinical use of immunosuppressive drugs in rheumatic lung diseases.
  • To highlight sequential therapies and novel regimens.
  • To discuss efficacy in scleroderma-associated interstitial lung disease.

Main Methods:

  • Literature review of immunosuppressive drug mechanisms, administration, and clinical applications.
  • Emphasis on sequential therapy protocols (e.g., cyclophosphamide induction, methotrexate/azathioprine maintenance).

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  • Inclusion of recent advancements in treating severe vasculitis and scleroderma-related interstitial lung disease.

    • Main Results:

    • Cyclophosphamide, chlorambucil, azathioprine, methotrexate, leflunomide, cyclosporine, and mycophenolate mofetil are reviewed.
    • Sequential therapies (cyclophosphamide followed by methotrexate or azathioprine) are effective for remission induction and maintenance.
    • Cyclophosphamide shows significant benefit in scleroderma-associated interstitial lung disease, indicating efficacy in rheumatic disease-associated interstitial fibrosis.

    Conclusions:

    • Immunosuppressive drugs remain crucial for managing rheumatic lung diseases.
    • Sequential therapies offer a structured approach to treatment.
    • Evidence supports cyclophosphamide's efficacy in scleroderma-associated interstitial lung disease, paving the way for optimized therapeutic strategies.