Azathioprine vs. Mycophenolate Mofetil for Myositis-Related ILD

Previous research has established azathioprine (AZA) and mycophenolate mofetil (MMF) as effective treatments for interstitial lung disease (ILD), but the primary focus has been connective tissue disease-associated ILD. In this retrospective study, researchers compared lung function and prednisone dose associated with AZA and MMF in myositis-related ILD (M-ILD). M-ILD patients were included in the study if they received AZA or MMF and no other steroid-sparing agents. Researchers adjusted for patient sex, age, antisynthetase antibody, and smoking status. They evaluated the change in forced vital capacity (FVC) % predicted, diffusing capacity of the lungs for carbon monoxide (DLCO) % predicted, and prednisone dose. A total of 110 patients were included in the study: 66 were treated with AZA, and 44 with MMF. The AZA cohort, compared to the MMF cohort, had a significantly lower mean FVC % predicted and DLCO % predicted at the start of treatment. Improvement in FVC % predicted was observed in both groups, and prednisone dose was reduced over two to five years. Improvement in DLCO % predicted was only observed in the AZA group. In adjusted analysis, posttreatment FVC % predicted and DLCO % predicted did not largely differ between the groups, but at 36 months, the AZA group had a 6.6 mg lower dose of prednisone. More adverse events occurred in the AZA group (33.3%) compared to the MMF group (13.6%). Read more