TOPLINE:

In patients with limited cutaneous systemic sclerosis (SSc), mycophenolate mofetil was primarily prescribed to those with a history of interstitial lung disease and myositis, and it reduced the risk for vascular complications requiring escalation of vasoactive or vasodilator therapies by 95%.

METHODOLOGY:

• Researchers conducted a retrospective analysis of 1435 patients with limited cutaneous SSc from the Italian SPRING registry to assess the purpose of starting mycophenolate mofetil treatment and its effect on the escalation of vasoactive or vasodilator therapy.
• A quasi-experimental cohort design was used, and a time-dependent propensity score was employed for matching patients treated with mycophenolate mofetil for at least 3 months to those not exposed to mycophenolate mofetil (n = 107 each; median follow-up duration, 40.5 months).
• The endpoint was the escalation of vasodilator or vasoactive treatment, defined as the introduction of specific treatments to the existing regimen due to uncontrolled or newly diagnosed vascular complications.

TAKEAWAY:

• Overall, the median observation period from diagnosis to last follow-up was 105 months, with mycophenolate mofetil prescribed to 10.6% of patients.
• Patients who received mycophenolate mofetil were more likely to be male, positive for anti-Scl70, and negative for anticentromere antibody and have a history of interstitial lung disease, myositis, and exposure to rituximab.
• The incidence of treatment escalation events was 0.3 per 100 patient-years in the mycophenolate mofetil group compared with 5.4 per 100 patient-years in the control group, with the cumulative incidence of events at the end of follow-up being 2.5% and 21.8%, respectively.
• Mycophenolate mofetil treatment was associated with a 95% reduction in the risk for vascular complications requiring treatment escalation (hazard ratio, 0.05; P = .004).

IN PRACTICE:

“Our data suggest that MMF [mycophenolate mofetil] exerts a protective effect against vascular complications,” the authors wrote.

SOURCE:

The study was led by Enrico De Lorenzis, MD, PhD, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. It was published online on December 29, 2025, in Arthritis Care & Research.

LIMITATIONS:

Potential unmeasured confounding variables could affect the estimated effect. Only long-term survivors were included, which may limit the generalizability of the findings. Data on exposure to smoke and specific mycophenolate mofetil dosages were unavailable.

DISCLOSURES:

No specific funding was reported by the authors. Some authors reported receiving grants, consulting fees, support for meetings, and payments or honoraria and having other ties with various sources including trusts, foundations, and pharmaceutical companies. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.