Systemic sclerosis & Raynaud's
Mycophenolate Mofetil Treatment Reduces the Risk of Treatment Escalation Due to Vascular Complications in Limited Cutaneous Systemic Sclerosis: Emulation of a Target Trial From the Italian Rheumatology Society SPRING Registry
Authors' conclusion
In patients with lcSSc, the introduction of MMF has reduced the need for escalation of vasoactive or vasodilator treatment, suggesting that it may also help to prevent vascular complications, which frequently affect patients with lcSSc.
Study context
- Population
- Patients with limited cutaneous systemic sclerosis (lcSSc) enrolled in the Italian Systemic Sclerosis Progression Investigation (SPRING) registry152 prescribed mycophenolate mofetil (MMF)
- Participants
- 1,435 patients
- Exposure
- MMF-treated vs matched MMF-untreated controls
- MMFn = 107
- Outcome
- Escalation of vasoactive or vasodilator treatment (introduction of iloprost, endothelin receptor antagonists or phosphodiesterase-5 inhibitors on top of ongoing treatment) because of uncontrolled or newly diagnosed vascular complications
- Follow-up
- Up to 60 months
Methodological detailsretrospective registry cohort study, roll-entry time-dependent propensity score matched, Cox hazards model
- Retrospective registry cohort study
- Roll-entry time-dependent propensity score matched
- Cox hazards model
Main finding
As reported in the abstract
Vasoactive/vasodilator treatment escalation events related to digital ulcers, incidence per 100 patient-years · median follow-up 40.5 months (IQR 23.3-60.0)
Hazard ratio
0.05
95% CI 0.01–0.38
P = 0.004
By group
Observational data: associations, not effects.
Further findings
Factors associated with MMF prescription
- MMF prescription more common in men and in anti-Scl70 positive, anticentromere negative patients with ILD, myositis, and without a history of digital ulcers
Original publication
Mycophenolate Mofetil Treatment Reduces the Risk of Treatment Escalation Due to Vascular Complications in Limited Cutaneous Systemic Sclerosis: Emulation of a Target Trial From the Italian Rheumatology Society SPRING Registry. Arthritis Care Res (Hoboken). Published 17 April 2026. doi:10.
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