Clinically significant interstitial lung disease affects patientswith systemic sclerosis (scleroderma) and is a cause of morbidityand mortality in approximately 40 percent of these patients.1Management of this condition remains difficult and controversial.2,3In this issue of the Journal, Tashkin and colleagues4 reportthe results of a multicenter, placebo-controlled trial of oralcyclophosphamide in patients with well-defined, symptomaticscleroderma-related interstitial lung disease and alveolitis.They document small but statistically significant improvementsin lung function and symptoms with cyclophosphamide administeredover the course of one year the first positive resultsof a placebo-controlled trial in this field.
From the Division of Pulmonary and Critical Care Medicine (F.J.M.) and the Division of Rheumatology, Department of Internal Medicine (W.J.M.), University of Michigan Health System, Ann Arbor.
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