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Mycophenolate Mofetil in Systemic Sclerosis With Subclinical Interstitial Lung Disease (SSc-mILD)

Primary Purpose

Systemic Sclerosis With Lung Involvement, Systemic Sclerosis, Interstitial Lung Disease

Status
Not yet recruiting
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
Mycophenolate Mofetil
Placebo
Sponsored by
Centre hospitalier de l'Université de Montréal (CHUM)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Systemic Sclerosis With Lung Involvement focused on measuring Systemic sclerosis, Mycophenolate mofetil, Interstitial lung disease

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Able and willing to provide informed consent and adhere to study protocol; Women and men of all race/ethnicity, aged 18 years and older; SSc based on 2013 ACR-EULAR classification criteria; Presence of interstitial lung disease on HRCT scan, obtained within 12 months before screening, that shows fibrosis affecting less than 20% of the lungs, as confirmed by an expert radiologist; Diagnosis of ILD within 7 years before screening; Forced vital capacity of 80% predicted and above, on pulmonary function tests obtained within 6 months before screening; Able to communicate in French or English; Exclusion Criteria: Progressive pulmonary fibrosis, defined as at least two of three criteria (worsening symptoms, radiological progression, and physiological progression) occurring within the past year with no alternative explanation, as defined by the 2022 ATS/ERS/JRS/ALAT Clinical Practice Guideline; Use of medications with putative lung disease-modifying properties: Current use of MMF, mycophenolic acid, azathioprine, calcineurin inhibitors (e.g. tacrolimus, cyclosporin A), tocilizumab, nintedanib, pirfenidone or corticosteroids (Prednisone equivalent dose >10 mg/day) at time of screening Cyclophosphamide within one year prior to screening Rituximab within 6 months prior to screening Cell therapies (including stem cell transplantation) within one year prior to screening Current use of other biological, targeted synthetic or investigational products with immunosuppressive effects (e.g. TNF inhibitors, abatacept, tofacitinib) at time of screening Any contraindication to MMF, including: Pregnancy and/or breastfeeding Female of childbearing potential not using reliable method of contraception Persistent leucopenia (white blood cell count <3.0 x103/μL) Persistent thrombocytopenia (platelet count <100 x103/μL) Persistent anemia (hemoglobin <100 g/L) Baseline liver enzymes (alanine transaminase (ALT) or aspartate transaminase (AST)) or bilirubin >1.5 times the upper limit of normal, other than due to Gilbert's disease Uncontrolled congestive heart failure Active infection (lung or elsewhere) Active solid or hematological malignancy (other than basal cell cancer of the skin or cervical carcinoma in situ removed entirely by biopsy) Active peptic ulcer disease Other serious concomitant medical illness, unreliability or drug abuse that might compromise the patient's ability to safely take MMF Use of drugs or products with significant interactions with MMF

Sites / Locations

  • St-Joseph's Healthcare Hamilton
  • Centre hospitalier de l'Université de Montréal (CHUM)
  • Jewish General Hospital - CIUSSS-COMTL

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Mycophenolate mofetil

Placebo

Arm Description

2 to 4 capsules of mycophenolate mofetil twice daily.

2 to 4 capsules of placebo twice daily.

Outcomes

Primary Outcome Measures

Total number of potentially eligible patients identified per site
Proportion of potentially eligible patients who provide consent per site
Proportion of consented participants who meet the eligibility criteria per site
Monthly rate of randomized participants per site
Adherence to treatment as assessed by Participant Dosing Diaries
Drug adherence rate as assessed by Pharmacy Accountability Logs
Adherence to the study protocol as assessed by the number of protocol deviations
Proportion of participants intolerant to the study drug who discontinue trial treatment
Proportion of participants receiving the allocated treatment at 48 weeks
Proportion of participants receiving the allocated treatment at 96 weeks
Proportion of participants with complete primary efficacy outcome data at 48 weeks
Proportion of participants with complete primary efficacy outcome data at 96 weeks
Proportion of participants lost to follow-up

Secondary Outcome Measures

Frequency of treatment-related adverse events
Incidence and severity of AEs, with severity determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0)

Full Information

First Posted
February 7, 2023
Last Updated
October 13, 2023
Sponsor
Centre hospitalier de l'Université de Montréal (CHUM)
Collaborators
McGill University, University of Calgary, St. Joseph's Healthcare Hamilton, Jewish General Hospital, Canadian Institutes of Health Research (CIHR), Sclérodermie Québec
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1. Study Identification

Unique Protocol Identification Number
NCT05785065
Brief Title
Mycophenolate Mofetil in Systemic Sclerosis With Subclinical Interstitial Lung Disease
Acronym
SSc-mILD
Official Title
Randomized Double-Blind Placebo-Controlled Clinical Trial to Assess the Efficacy of Mycophenolate Mofetil in Subclinical Interstitial Lung Disease Associated With Systemic Sclerosis: a Feasibility Study
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 2023 (Anticipated)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre hospitalier de l'Université de Montréal (CHUM)
Collaborators
McGill University, University of Calgary, St. Joseph's Healthcare Hamilton, Jewish General Hospital, Canadian Institutes of Health Research (CIHR), Sclérodermie Québec

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The goal of this pilot study is to assess the feasibility of a larger study on the efficacy of mycophenolate mofetil in people diagnosed with systemic sclerosis with mild lung involvement. Participants will be recruited over 12 months at 3 academic centers and assigned randomly to receive either mycophenolate mofetil or placebo, a look-alike substance that contains no active drug, for 96 weeks.
Detailed Description
Background: Systemic sclerosis (SSc, scleroderma) is a rare but life-threatening systemic autoimmune disease characterized by microvasculopathy, serum autoantibodies, inflammation and fibrosis of the skin and internal organs. Early rapidly progressive SSc remains the most lethal autoimmune rheumatic disease, with over 60% mortality at 5 years in high-risk patients. Interstitial lung disease (ILD) is the leading cause of SSc-related mortality and affects over half of SSc patients. SSc-ILD is currently treated with immunosuppressive and anti-fibrotic drugs, with the first-line treatment being mycophenolate mofetil (MMF), although treatments have modest benefits when initiated in advanced stages of disease. Emerging data suggest that earlier treatment, when lung function is still normal despite evidence of ILD on computed tomography scan ("subclinical SSc-ILD"), may lead to improved outcomes, suggesting a window of treatment opportunity. Research Aims: The goal of the proposed pilot RCT is to establish the feasibility of a phase III RCT that will assess the efficacy of MMF in subclinical SSc-ILD. Specifically, we aim to: Determine the rate of patient recruitment at three centers over one year, and identify barriers and solutions to recruitment; Determine the proportion of participants receiving the allocated treatment and with complete primary efficacy outcome data at 48 and 96 weeks; and Generate preliminary data on clinical efficacy outcomes that will contribute information to the analysis of the phase III trial through a Bayesian inference framework. Methods: Participants will be adults with SSc, ILD diagnosed within the past 3 years and a normal forced vital capacity (≥ 80%). Participants will be recruited over 12 months at 3 academic centers affiliated to the Canadian Scleroderma Research Group. Eligible participants will be assigned using stratified randomization to receive either MMF (up to 2 grams daily) or placebo for 96 weeks. The primary feasibility outcome will be the rate of recruitment per site over 12 months. A Bayesian approach will be used to estimate the probability of reaching the target sample size based on observed recruitment rates, with decision rules to continue, adapt, or stop the trial. Data collected on the primary clinical efficacy outcome (annual rate of decline in forced vital capacity over 96 weeks) will be used to inform the analysis of the phase III trial (as an informative prior) through a Bayesian inference framework.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Systemic Sclerosis With Lung Involvement, Systemic Sclerosis, Interstitial Lung Disease
Keywords
Systemic sclerosis, Mycophenolate mofetil, Interstitial lung disease

7. Study Design

Primary Purpose
Other
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Patients will be randomized to treatment group or placebo group in a 1:1 ratio and stratified according to the presence of anti-topoisomerase I autoantibody.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
The participant, the physician, the study investigators and the research personnel will be blinded to treatment allocation, whereas the dispensing pharmacy will not.
Allocation
Randomized
Enrollment
35 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Mycophenolate mofetil
Arm Type
Experimental
Arm Description
2 to 4 capsules of mycophenolate mofetil twice daily.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
2 to 4 capsules of placebo twice daily.
Intervention Type
Drug
Intervention Name(s)
Mycophenolate Mofetil
Intervention Description
The participant will receive 500 mg to 1000 mg twice daily of mycophenolate mofetil administered orally for 96 weeks. The dose scheduling will be as follow: Weeks 1 and 2: 500 mg twice a day Weeks 3 and 4: 750 mg twice a day Weeks 5 to 96: 1000 mg twice a day
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
The participant will receive 500 mg to 1000 mg twice daily of placebo administered orally for 96 weeks. The dose scheduling will be as follow: Weeks 1 and 2: 500 mg twice a day Weeks 3 and 4: 750 mg twice a day Weeks 5 to 96: 1000 mg twice a day
Primary Outcome Measure Information:
Title
Total number of potentially eligible patients identified per site
Time Frame
Over one year
Title
Proportion of potentially eligible patients who provide consent per site
Time Frame
Over one year
Title
Proportion of consented participants who meet the eligibility criteria per site
Time Frame
Over one year
Title
Monthly rate of randomized participants per site
Time Frame
Over one year
Title
Adherence to treatment as assessed by Participant Dosing Diaries
Time Frame
From the first dose to the last dose taken for each participant, up to 96 weeks
Title
Drug adherence rate as assessed by Pharmacy Accountability Logs
Time Frame
From the first dose to the last dose taken for each participant, up to 96 weeks
Title
Adherence to the study protocol as assessed by the number of protocol deviations
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Proportion of participants intolerant to the study drug who discontinue trial treatment
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Proportion of participants receiving the allocated treatment at 48 weeks
Time Frame
At 48 weeks
Title
Proportion of participants receiving the allocated treatment at 96 weeks
Time Frame
At 96 weeks
Title
Proportion of participants with complete primary efficacy outcome data at 48 weeks
Time Frame
At 48 weeks
Title
Proportion of participants with complete primary efficacy outcome data at 96 weeks
Time Frame
At 96 weeks
Title
Proportion of participants lost to follow-up
Time Frame
Over total study period (up to 96 weeks per participant)
Secondary Outcome Measure Information:
Title
Frequency of treatment-related adverse events
Description
Incidence and severity of AEs, with severity determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0)
Time Frame
Over total study period (up to 96 weeks per participant)
Other Pre-specified Outcome Measures:
Title
Annual rate of decline in percent (%) predicted forced vital capacity (FVC) over 48 weeks
Time Frame
Over 48 weeks
Title
Annual rate of decline in percent (%) predicted forced vital capacity (FVC) over 96 weeks
Time Frame
Over 96 weeks
Title
Proportion of participants having clinically meaningful progression
Description
Clinically meaningful progression defined by the Outcome Measures in Rheumatology (OMERACT) for connective tissue disease-associated interstitial lung diseases (CTD-ILD) (defined as a ≥10% relative decline in FVC from baseline, or a ≥5% to <10% relative decline in FVC associated with a ≥15% relative decline in diffusion capacity [DLCO])
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Time to clinically meaningful progression
Description
Clinically meaningful progression as defined by Outcome Measures in Rheumatology (OMERACT) for connective tissue disease- associated interstitial lung diseases (CTD-ILD) (defined as a ≥10% relative decline in FVC from baseline, or a ≥5% to <10% relative decline in FVC associated with a ≥15% relative decline in diffusion capacity [DLCO])
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Proportion of participants having an absolute decrease in FVC of at least 3.3% predicted
Description
An absolute decrease in FVC of at least 3.3% predicted was proposed as the minimal clinically important difference estimate for worsening of FVC in patients with SSc-ILD.
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Time to an absolute decrease in FVC of at least 3.3% predicted
Description
An absolute decrease in FVC of at least 3.3% predicted was proposed as the minimal clinically important difference estimate for worsening of FVC in patients with SSc-ILD.
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Proportion of participants having progressive pulmonary fibrosis
Description
Progressive pulmonary fibrosis defined by 2022 ATS/ERS/JRS/ALAT guidelines
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Time to progressive pulmonary fibrosis
Description
Progressive pulmonary fibrosis defined by 2022 ATS/ERS/JRS/ALAT guidelines
Time Frame
Over total study period (up to 96 weeks per participant)
Title
Annual rate of decline in percent (%) predicted total lung capacity over 48 weeks
Time Frame
Over 48 weeks
Title
Annual rate of decline in percent (%) predicted total lung capacity over 96 weeks
Time Frame
Over 96 weeks
Title
Annual rate of decline in percent (%) predicted diffusion capacity for carbon monoxide (DLCO) over 48 weeks
Time Frame
Over 48 weeks
Title
Annual rate of decline in percent (%) predicted DLCO over 96 weeks
Time Frame
Over 96 weeks
Title
Change from baseline in percent (%) extent of ILD, ground-glass opacities, reticular infiltrates and honeycombing, and in pulmonary vessel volume at 48 weeks
Description
Measured on high-resolution computed tomography chest scan using automated lung texture analysis
Time Frame
At 48 weeks
Title
Change from baseline in percent (%) extent of ILD, ground-glass opacities, reticular infiltrates and honeycombing, and in pulmonary vessel volume at 96 weeks
Description
Measured on high-resolution computed tomography chest scan using automated lung texture analysis
Time Frame
At 96 weeks
Title
Change from baseline in St-George Respiratory Questionnaire at 48 weeks
Description
Scores range from 0 to 100, with higher scores indicating more limitations.
Time Frame
At 48 weeks
Title
Change from baseline in St-George Respiratory Questionnaire at 96 weeks
Description
Scores range from 0 to 100, with higher scores indicating more limitations.
Time Frame
At 96 weeks
Title
Change from baseline in Leicester Cough Questionnaire at 48 weeks
Description
Scores (total) range from 3 to 21, with higher scores indicating less limitations.
Time Frame
At 48 weeks
Title
Change from baseline in Leicester Cough Questionnaire at 96 weeks
Description
Scores (total) range from 3 to 21, with higher scores indicating less limitations.
Time Frame
At 96 weeks
Title
Change from baseline in health assessment questionnaire modified for scleroderma at 48 weeks
Description
The SHAQ consists of the Health assessment questionnaire (HAQ) and visual analogue scales for pain, patient global assessment, vascular, digital ulcers, lung involvement and gastrointestinal involvement. Scores range from 0 to 3, with higher scores indicating more limitations.
Time Frame
At 48 weeks
Title
Change from baseline in health assessment questionnaire modified for scleroderma at 96 weeks
Description
The SHAQ consists of the Health assessment questionnaire (HAQ) and visual analogue scales for pain, patient global assessment, vascular, digital ulcers, lung involvement and gastrointestinal involvement. Scores range from 0 to 3, with higher scores indicating more limitations.
Time Frame
At 96 weeks
Title
Change from baseline in 36-items short form survey (SF-36) at 48 weeks
Description
Eight scales with scores range from 0 to 100, with higher scores indicating less limitations.
Time Frame
At 48 weeks
Title
Change from baseline in 36-items short form survey (SF-36) at 96 weeks
Description
Eight scales with scores ranging from 0 to 100, with higher scores indicating less limitations.
Time Frame
At 96 weeks
Title
Change from baseline in EuroQoL five dimensions (EQ-5D-5L) at 48 weeks
Description
The EQ-5D-5L questionnaire possesses 5 levels for each of the five dimensions. The five dimensions are mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, with the following possible five responses: no problems, slight problems, moderate problems, severe problems, unable to/extreme problems. Scores are converted into an index value ranging from 0 to 1, with higher scores indicating better health state.
Time Frame
At 48 weeks
Title
Change from baseline in EuroQoL five dimensions (EQ-5D-5L) at 96 weeks
Description
The EQ-5D-5L questionnaire possesses 5 levels for each of the five dimensions. The five dimensions are mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, with the following possible five responses: no problems, slight problems, moderate problems, severe problems, unable to/extreme problems. Scores are converted into an index value ranging from 0 to 1, with higher scores indicating better health state.
Time Frame
At 96 weeks
Title
Change from baseline in patient global assessment at 48 weeks
Description
Visual analogue scale from 0 to 10, with higher scores indicating worse disease.
Time Frame
At 48 weeks
Title
Change from baseline in patient global assessment at 96 weeks
Description
Visual analogue scale from 0 to 10, with higher scores indicating worse disease.
Time Frame
At 96 weeks
Title
Change from baseline in physician global assessment at 48 weeks
Description
Visual analogue scale from 0 to 10, with higher scores indicating worse disease.
Time Frame
At 48 weeks
Title
Change from baseline in physician global assessment at 96 weeks
Description
Visual analogue scale from 0 to 10, with higher scores indicating worse disease.
Time Frame
At 96 weeks
Title
Change from baseline in 6-minute walk oxygen saturation at 48 weeks
Description
Oxygen saturation at nadir during the 6-minute walk test
Time Frame
At 48 weeks
Title
Change from baseline in 6-minute walk oxygen desaturation at 96 weeks
Description
Oxygen saturation at nadir during the 6-minute walk test
Time Frame
At 96 weeks
Title
Change from baseline in modified Rodnan skin score (mRSS) at 48 weeks
Description
Scores range from 0 to 51, with higher scores indicating more skin involvement.
Time Frame
At 48 weeks
Title
Change from baseline in modified Rodnan skin score (mRSS) at 96 weeks
Description
Scores range from 0 to 51, with higher scores indicating more skin involvement.
Time Frame
At 96 weeks
Title
Change from baseline in nailfold capillary density at 48 weeks
Description
Mean number of capillaries per mm
Time Frame
At 48 weeks
Title
Change from baseline in nailfold capillary density at 96 weeks
Description
Mean number of capillaries per mm
Time Frame
At 96 weeks
Title
Change from baseline in nailfold capillaroscopy abnormalities and patterns at 48 weeks
Description
Ectasias/megacapillaries are scored using a semi-quantitative scale (0 = no, 1 = ≤33%, 2= 33-66%, and 3 = ≥66% abnormalities/linear mm)
Time Frame
At 48 weeks
Title
Change from baseline in nailfold capillaroscopy abnormalities and patterns at 96 weeks
Description
Ectasias/megacapillaries are scored using a semi-quantitative scale (0 = no, 1 = ≤33%, 2= 33-66%, and 3 = ≥66% abnormalities/linear mm)
Time Frame
At 96 weeks
Title
Change from baseline in quantitative SSc autoantibody titers at 48 weeks
Time Frame
At 48 weeks
Title
Change from baseline in quantitative SSc autoantibody titers at 96 weeks
Time Frame
At 96 weeks
Title
Change from baseline in Krebs von Lungen 6 (KL-6) titers at 48 weeks
Time Frame
At 48 weeks
Title
Change from baseline in Krebs von Lungen 6 (KL-6) titers at 96 weeks
Time Frame
At 96 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able and willing to provide informed consent and adhere to study protocol; Women and men of all race/ethnicity, aged 18 years and older; SSc based on 2013 ACR-EULAR classification criteria; Presence of interstitial lung disease on HRCT scan, obtained within 12 months before screening, that shows fibrosis affecting less than 20% of the lungs, as confirmed by an expert radiologist; Diagnosis of ILD within 7 years before screening; Forced vital capacity of 80% predicted and above, on pulmonary function tests obtained within 6 months before screening; Able to communicate in French or English; Exclusion Criteria: Progressive pulmonary fibrosis, defined as at least two of three criteria (worsening symptoms, radiological progression, and physiological progression) occurring within the past year with no alternative explanation, as defined by the 2022 ATS/ERS/JRS/ALAT Clinical Practice Guideline; Use of medications with putative lung disease-modifying properties: Current use of MMF, mycophenolic acid, azathioprine, calcineurin inhibitors (e.g. tacrolimus, cyclosporin A), tocilizumab, nintedanib, pirfenidone or corticosteroids (Prednisone equivalent dose >10 mg/day) at time of screening Cyclophosphamide within one year prior to screening Rituximab within 6 months prior to screening Cell therapies (including stem cell transplantation) within one year prior to screening Current use of other biological, targeted synthetic or investigational products with immunosuppressive effects (e.g. TNF inhibitors, abatacept, tofacitinib) at time of screening Any contraindication to MMF, including: Pregnancy and/or breastfeeding Female of childbearing potential not using reliable method of contraception Persistent leucopenia (white blood cell count <3.0 x103/μL) Persistent thrombocytopenia (platelet count <100 x103/μL) Persistent anemia (hemoglobin <100 g/L) Baseline liver enzymes (alanine transaminase (ALT) or aspartate transaminase (AST)) or bilirubin >1.5 times the upper limit of normal, other than due to Gilbert's disease Uncontrolled congestive heart failure Active infection (lung or elsewhere) Active solid or hematological malignancy (other than basal cell cancer of the skin or cervical carcinoma in situ removed entirely by biopsy) Active peptic ulcer disease Other serious concomitant medical illness, unreliability or drug abuse that might compromise the patient's ability to safely take MMF Use of drugs or products with significant interactions with MMF
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Joanie Vaillancourt, MSc
Phone
514-890-8000
Ext
13876
Email
joanie.vaillancourt.chum@ssss.gouv.qc.ca
First Name & Middle Initial & Last Name or Official Title & Degree
Sabrina Hoa, MD
Phone
514-890-8000
Ext
28830
Email
sabrina.anh-tu.hoa.med@ssss.gouv.qc.ca
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sabrina Hoa, MD
Organizational Affiliation
Centre hospitalier de l'Université de Montréal (CHUM)
Official's Role
Principal Investigator
Facility Information:
Facility Name
St-Joseph's Healthcare Hamilton
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 4A6
Country
Canada
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Maggie Larche, MD
First Name & Middle Initial & Last Name & Degree
Maggie Larche, MD
Facility Name
Centre hospitalier de l'Université de Montréal (CHUM)
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2X 3E4
Country
Canada
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joanie Vaillancourt, MSc
Phone
514-890-8000
Ext
13876
Email
joanie.vaillancourt.chum@ssss.gouv.qc.ca
First Name & Middle Initial & Last Name & Degree
Sabrina Hoa, MD
Facility Name
Jewish General Hospital - CIUSSS-COMTL
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3T 1E2
Country
Canada
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marie Hudson, MD
First Name & Middle Initial & Last Name & Degree
Marie Hudson, MD

12. IPD Sharing Statement

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Mycophenolate Mofetil in Systemic Sclerosis With Subclinical Interstitial Lung Disease

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