Cyclophosphamide for Scleroderma Lung Disease

Clinically significant interstitial lung disease affects patients with systemic sclerosis (scleroderma) and is a cause of morbidity and mortality in approximately 40 percent of these patients.1 Management of this condition remains difficult and controversial.2,3 In this issue of the Journal, Tashkin and colleagues4 report the results of a multicenter, placebo-controlled trial of oral cyclophosphamide in patients with well-defined, symptomatic scleroderma-related interstitial lung disease and alveolitis. They document small but statistically significant improvements in lung function and symptoms with cyclophosphamide administered over the course of one year — the first positive results of a placebo-controlled trial in this field.How . . .