MMF Shows Promise in Juvenile Scleroderma

Mycophenolate mofetil demonstrated comparable disease control with fewer adverse effects.

To compare the effectiveness and tolerability of mycophenolate mofetil (MMF) and methotrexate (MTX) in treating juvenile localized scleroderma (JLS).

Both MMF and MTX achieved inactive disease status within 12 months with no significant differences in improvement rates.
MMF demonstrated significantly fewer adverse effects compared to MTX, including lower rates of nausea, fatigue, anxiety, and anticipatory vomiting.
Disease flare occurred in 25% of patients overall, with no significant differences in flare-free survival between treatment groups.

These findings suggest that MMF may be a viable first-line treatment option for JLS, offering similar efficacy to MTX with improved tolerability.

Retrospective, nonrandomized design with unequal treatment group sizes.
MMF was often initiated after longer disease duration or MTX intolerance, potentially biasing response estimates.
Adverse effects were assessed through clinical interviews rather than validated measures.
The study was not powered to detect small differences in efficacy.

Prospective, randomized, noninferiority trials are needed to confirm these findings and inform future treatment guidelines.