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Meta-Analysis
. 2008;10(5):R124.
doi: 10.1186/ar2534. Epub 2008 Oct 20.

Effects of cyclophosphamide on pulmonary function in patients with scleroderma and interstitial lung disease: a systematic review and meta-analysis of randomized controlled trials and observational prospective cohort studies

Carlotta Nannini  1 , Colin P West, Patricia J Erwin, Eric L Matteson
Affiliations
Meta-Analysis

Effects of cyclophosphamide on pulmonary function in patients with scleroderma and interstitial lung disease: a systematic review and meta-analysis of randomized controlled trials and observational prospective cohort studies

Carlotta Nannini et al. Arthritis Res Ther. 2008.

Erratum in

  • Arthritis Res Ther. 2009;11(2):408

Abstract

Introduction: The purpose of the present study was to systematically review the effect of cyclophosphamide treatment on pulmonary function in patients with systemic sclerosis and interstitial lung disease.

Methods: The primary outcomes were the mean change in forced vital capacity and in diffusing capacity for carbon monoxide after 12 months of therapy in patients treated with cyclophosphamide.

Results: Three randomized clinical trials and six prospective observational studies were included for analysis. In the pooled analysis, the forced vital capacity and the diffusing capacity for carbon monoxide predicted values after 12 months of therapy were essentially unchanged, with mean changes of 2.83% (95% confidence interval = 0.35 to 5.31) and 4.56% (95% confidence interval = -0.21 to 9.33), respectively.

Conclusions: Cyclophosphamide treatment in patients with systemic sclerosis-related interstitial lung disease does not result in clinically significant improvement of pulmonary function.

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Figures

Figure 1
Figure 1
Meta-analysis study selection. DLCO, diffusing capacity for carbon monoxide; FVC, forced vital capacity.
Figure 2
Figure 2
Forest plot of the overall meta-analysis results in the randomized clinical trials. Comparison of (a) the forced vital capacity (FVC) and (b) the diffusing capacity for carbon monoxide (DLCO) at 12 months for patients with scleroderma lung disease treated with cyclophosphamide versus a control group. See Table 2 for study details. RCT, randomized clinical trial; SE, standard error; CI, confidence interval; Chi2, chi-squared; df, degree of freedom; I2, I-squared; Z, Z value; Mean difference, weighted mean difference; Random, random-effects model.
Figure 3
Figure 3
Forest plot of the overall meta-analysis results in randomized clinical trials and observational studies. Changes after 12 months of therapy versus baseline in (a) the forced vital capacity (FVC) and (b) the diffusing capacity for carbon monoxide (DLCO), pooled from the cyclophosphamide (CYC) arms of randomized clinical trials and observational studies. See Tables 2 and 3 for study details. SE, standard error; CI, confidence interval; Chi2, chi-squared; df, degree of freedom; I2, I-squared; Z, Z value; High Pred, high dose of prednisone; Low Pred, low dose of prednisone; Oral, oral administration; Pulse, intravenous administration; RCT, randomized clinical trial; Mean difference, weighted mean difference; Random, random-effects model.
See this image and copyright information in PMC

Comment in

References

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