Unfortunately, there is no clear answer. Dr. Wigley in the Johns Hopkins Scleroderma Center is part of a multicenter study looking at cyclophosphamide in scleroderma interstitial lung disease. Some earlier studies have suggested that cyclophosphamide is useful when there is active inflammation in the lung diagnosed with high resolution CT scan showing alveolitis, bronchoalveolar lavage, or rapidly declining PFTs. But other agents such as azathioprine (Imuran) have also been used. There is no clear answer as of yet.
About Alan Matsumoto, M.D.
Part-time Faculty, Division of Rheumatology
Johns Hopkins University