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Bruni C, Furst DE. The burning question: To use or not to use cyclophosphamide in systemic sclerosis. Eur J Rheumatol. 2020;7:S237-S241doi: 10.5152/eurjrheum.2020.19104.
Bruni, C., & Furst, D. E. (2020). The burning question: To use or not to use cyclophosphamide in systemic sclerosis. European journal of rheumatology, 7S237-S241. https://doi.org/10.5152/eurjrheum.2020.19104
Bruni, Cosimo, and Furst, Daniel E. "The burning question: To use or not to use cyclophosphamide in systemic sclerosis." European journal of rheumatology vol. 7 (2020): S237-S241. doi: https://doi.org/10.5152/eurjrheum.2020.19104
Bruni C, Furst DE. The burning question: To use or not to use cyclophosphamide in systemic sclerosis. Eur J Rheumatol. 2020 Oct;7:S237-S241. doi: 10.5152/eurjrheum.2020.19104. Epub 2020 Oct 01. PMID: 33164737; PMCID: PMC7647679.
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Eur J Rheumatol. 2020 Oct;7:S237-S241. doi: 10.5152/eurjrheum.2020.19104. Epub 2020 Oct 01.

The burning question: To use or not to use cyclophosphamide in systemic sclerosis.

European journal of rheumatology

Cosimo Bruni, Daniel E Furst

Affiliations

  1. Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy.
  2. Division of Rheumatology, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  3. Department of Medicine, University of Washington, Seattle, Washington, USA.

PMID: 33164737 PMCID: PMC7647679 DOI: 10.5152/eurjrheum.2020.19104

Abstract

Fibrosis, inflammation, and vasculopathy are the main determinants of systemic sclerosis (SSc) pathogenesis. Cyclophosphamide (CYC), an alkylating agent, has been used to treat skin fibrosis and interstitial lung diseases in SSc for many years and still represents a mainstay in hematopoietic stem cell transplantation. Despite significant effect in reducing lung functional impairment and skin tightness, CYC has a significant safety burden, including infection risk and bone marrow and bladder toxicity. Moreover, it can affect fertility and also cause a predisposition for cancer development in the future, particularly in the bladder. This review summarizes the current evidences regarding the use of CYC to treat SSc, its efficacy and safety profile, and currently available or tested alternative drugs for lung and skin involvement in SSc.

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