However, experience with using MMF for CTD-ILD is extremely limited. We conducted this study to analyze the experience of our center with treating CTD-ILD patients with MMF. Our primary objective was to evaluate the safety and tolerability of using MMF in a heterogeneous sample of patients with various CTD-ILDs. A secondary objective of this study was to examine the impact of MMF on pulmonary physiology in these patients.
After a waiver of informed consent was granted by the National Jewish Medical and Research Center Institutional Review Board, we identified all patients who were ever treated with MMF for CTD-ILD at our institution. During the time frame of the study, the authors (J.S., A.F., G.C., S.F., R.M., and K.B.) were the only physicians at our institution who prescribed MMF or followed up patients receiving MMF for this indication; therefore, we were able to identify all potential subjects. there
All patients who received MMF primarily for their CTD-ILD and returned to our institution for at least one follow-up visit were included in this study. Each subject satisfied American College of Rheumatology criteria for a specific CTD diagnosis as applied by board-certified rheumatologists (R.M. or A.F.). Subjects with undifferentiated CTD (UCTD) had symptoms and diagnostic studies consistent with a systemic autoimmune disorder but lacked full diagnostic criteria for a more classifiable condition. Each diagnosis of ILD was made using one of two methods: (1) a diagnostic surgical lung biopsy, as interpreted by an expert pulmonary pathologist; or (2) abnormalities on chest HRCT interpreted by an expert thoracic radiologist as consistent with diffuse parenchymal lung disease.
We reviewed the complete medical records of included subjects and abstracted data pertaining to the following: demographics, the diagnosis of and therapies for both the CTD and ILD components of their disorder, treatments and treatment-related side effects, and pulmonary physiology before and after the initiation of MMF. Vital status was ascertained via query of the Social Security Death Index on November 1, 2005. Four subjects from this study were included in a previously published ab-stract.