{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:12:54Z","timestamp":1789053174872,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T00:00:00Z","timestamp":1490313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000940","name":"Arthritis Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000940","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the long\u2010term efficacy and tolerability of mycophenolate mofetil (<jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>) in patients with diffuse cutaneous systemic sclerosis (dc<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients enrolled in the Australian Scleroderma Cohort study with dc<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c and baseline modified Rodnan skin score (<jats:styled-content style=\"fixed-case\">mRSS<\/jats:styled-content>) \u2265 12 who were treated for a minimum of 12 months with <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> for the primary indication of skin disease were included and their prospectively collected data retrieved. Change in <jats:styled-content style=\"fixed-case\">mRSS<\/jats:styled-content>, the proportion with a clinically significant improvement (reduction in <jats:styled-content style=\"fixed-case\">mRSS<\/jats:styled-content> \u2265 5 from baseline) and adverse effects due to therapy were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010four participants treated with <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> were identified and of these, 42 met inclusion criteria. The mean age was 53 \u00b1 12 years, with mean disease duration at <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> commencement of 4.8 \u00b1 4.3 years. Twenty\u2010one participants (50%) commenced <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> within 2 years of disease onset and the mean duration of therapy was 2.7 \u00b1 1.7 years. The mean <jats:styled-content style=\"fixed-case\">mRSS<\/jats:styled-content> at baseline was 25.9 \u00b1 9.2 with a reduction of 3.7 \u00b1 7.1 (<jats:italic>P<\/jats:italic> = 0.07) after 1 year of therapy, 7.6 \u00b1 8.3 after 2 years (<jats:italic>P<\/jats:italic> = 0.01) and 10.5 \u00b1 10.3 after 5 years (<jats:italic>P<\/jats:italic> &lt; 0.01). Response to treatment was not affected by disease duration at <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> commencement or baseline skin score. Eighteen participants (43%) demonstrated clinically significant improvement after 1 year, increasing to 92% after 4 years. Two participants (5%) ceased <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> due to adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> was associated with a modest improvement in <jats:styled-content style=\"fixed-case\">mRSS<\/jats:styled-content> and was well tolerated in the treatment of dc<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c. Given the natural history of dc<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c where skin involvement can spontaneously improve, randomized, placebo\u2010controlled studies are required to confirm whether improvement can be attributed to <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content> therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13035","type":"journal-article","created":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T12:14:25Z","timestamp":1490357665000},"page":"481-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Long\u2010term efficacy and tolerability of mycophenolate mofetil therapy in diffuse scleroderma skin disease"],"prefix":"10.1111","volume":"20","author":[{"given":"Daniel","family":"Boulos","sequence":"first","affiliation":[{"name":"Department of Rheumatology Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene\u2010Siew","family":"Ngian","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Rajadurai","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Elford","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Rheumatology St Vincent's Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Proudman","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Discipline of Medicine University of Adelaide Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Owen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Austin Health Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Roddy","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Royal Perth Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandana","family":"Nikpour","sequence":"additional","affiliation":[{"name":"Department of Rheumatology St Vincent's Health Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Hill","sequence":"additional","affiliation":[{"name":"Discipline of Medicine University of Adelaide Adelaide South Australia Australia"},{"name":"Department of Rheumatology Queen Elizabeth Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Sahhar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Monash Health Melbourne Victoria Australia"},{"name":"Department of Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.2277"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2009.12.002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.096677"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.069518"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0162-3109(00)00190-9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010020181"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.111229"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep295"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.142000"},{"issue":"10","key":"e_1_2_8_11_1","article-title":"The Scleroderma Lung Study II (SLS II) shows that both oral Cyclophosphamide (CYC) and Mycophenolate Mofitil (MMF) are efficacious in treating progressive interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) [abstract]","volume":"67","author":"Clements PJTD","year":"2015","journal-title":"Arthritis Rheum"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204424"},{"key":"e_1_2_8_13_1","first-page":"1573","article-title":"Criteria for the classification of early systemic sclerosis","volume":"28","author":"LeRoy EC","year":"2001","journal-title":"J Rheumatol"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102015\u2010208024"},{"issue":"2","key":"e_1_2_8_15_1","first-page":"166","article-title":"Treatment of early diffuse systemic sclerosis skin disease","volume":"31","author":"Frech TM","year":"2013","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200112)44:12<2828::AID-ART470>3.0.CO;2-U"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205226"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199906)42:6<1194::AID-ANR16>3.0.CO;2-7"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23501"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24681"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055120"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200106)44:6<1351::AID-ART227>3.0.CO;2-I"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/35.4.364"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2861"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2007.07.021"},{"key":"e_1_2_8_26_1","first-page":"170","article-title":"Mycophenolate mofetil is an effective and safe option for the management of systemic sclerosis\u2010associated interstitial lung disease: results from the Australian Scleroderma Cohort Study","volume":"34","author":"Owen C","year":"2016","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.121043"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1756-185X.13035","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.13035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T20:47:40Z","timestamp":1696366060000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185X.13035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,24]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1111\/1756-185X.13035"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.13035","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,24]]},"assertion":[{"value":"2017-03-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}