Scleroderma

In a recent Reuters Health article, it was reported that the serial scanning of the thorax with high-resolution computed tomography (HRCT) is useful for monitoring the response of Sclerodermal lung disease to therapy, according to a further report in the November Chest.

The report focused on 98 patients with sclerodermal-interstitial lung disease who had completed one year of treatment with either cyclophosphamide or placebo in a randomized Scleroderma Lung Study. According to senior author Dr. Donald P. Tashkin, from the University of California, the cyclophosphamide produced significant improvements in pulmonary function and symptoms. Dr. Tashkin, and his colleagues also compared parenchymal abnormalities between baseline and follow-up HRCT scans.

Amongst the 49 patients in the cyclophosphamide arm, 14 had worse fibrosis scores at 12 months and 35 had scores that were not worse. In contrast, among the 49 patients in the placebo group, 26 had worse fibrosis scores at 12 months and 23 had scores that were not worse.

HRCT fibrosis scores correlated with pulmonary function and skin thickness scores, the investigators said, and changes in dyspnea over time showed moderate correlations with changes in fibrosis.

"Our findings provide a rationale for performing follow-up HRCT scans in patients with scleroderma interstitial lung disease undergoing treatment with oral cyclophosphamide or some other potentially active agent as a means of assessing the patient's response to therapy and determining whether additional treatment is needed in patients with HRCT evidence of progressive fibrosis despite their existing therapy," Dr. Tashkin told Reuters Health.

"HRCT scans provide an objective method of assessing changes in both inflammation and fibrosis in the lungs of patients with interstitial lung disease," he added. "They therefore provide a useful complement to measured changes in lung physiology."

For a link to the full and original article, click here.