Objectives: To assess the long-term efficacy and safety of single and multiple courses of rituximab therapy in systemic sclerosis (SSc) patients with and without lung disease. Methods: A total of 20 SSc patients with a diffuse disease were treated with rituximab. At baseline and during follow-up the lung involvement was evaluated with pulmonary function tests (FVC and DLCO) and with lung high-resolution computed tomography (HRCT). Results: The skin score, activity, and severity indices improved significantly after 12 months and at final follow-up compared to baseline.After 12 months, there was a significant increase of FVC and TLC compared to baseline (. p = 0.024 and p = 0.005, respectively), while the mean DLCO value remained stable.Considering the last available follow-up in six patients with restrictive lung disease at baseline, two patients (33.3%) experienced an increase of more than 10% of FVC, one patient had a decrease of FVC >10%, while in three patients FVC remained stable (50%). After the mean follow-up of 48.5 ± 20.4 months, among the patients with normal lung parameters at baseline, FVC remained stable in 12 (85.7%) and in one patient (14.3%) it increased by more than 10%. At the final follow-up, the alveolar and interstitial HRCT scores remained stable in more than 80% of patients, both in patients with and without restrictive lung disease at baseline. Conclusions: Anti-CD20 B cell depletion therapy is effective on skin involvement but seems also to preserve the pulmonary function, as supported by a stable or improved FVC and stable interstitial score, suggesting a possible role of rituximab as a modifying therapy overall in early diffuse SSc.

Bosello, S. L., De Luca, G., Rucco, M., Berardi, G., Falcione, M., Danza, F. M., Pirronti, T., Ferraccioli, G., Long-term efficacy of B cell depletion therapy on lung and skin involvement in diffuse systemic sclerosis, <<SEMINARS IN ARTHRITIS AND RHEUMATISM>>, 2015; 44 (4): 428-436. [doi:10.1016/j.semarthrit.2014.09.002] [http://hdl.handle.net/10807/169979]

Long-term efficacy of B cell depletion therapy on lung and skin involvement in diffuse systemic sclerosis

Bosello, S. L.;Pirronti, T.;Ferraccioli, G.
2015

Abstract

Objectives: To assess the long-term efficacy and safety of single and multiple courses of rituximab therapy in systemic sclerosis (SSc) patients with and without lung disease. Methods: A total of 20 SSc patients with a diffuse disease were treated with rituximab. At baseline and during follow-up the lung involvement was evaluated with pulmonary function tests (FVC and DLCO) and with lung high-resolution computed tomography (HRCT). Results: The skin score, activity, and severity indices improved significantly after 12 months and at final follow-up compared to baseline.After 12 months, there was a significant increase of FVC and TLC compared to baseline (. p = 0.024 and p = 0.005, respectively), while the mean DLCO value remained stable.Considering the last available follow-up in six patients with restrictive lung disease at baseline, two patients (33.3%) experienced an increase of more than 10% of FVC, one patient had a decrease of FVC >10%, while in three patients FVC remained stable (50%). After the mean follow-up of 48.5 ± 20.4 months, among the patients with normal lung parameters at baseline, FVC remained stable in 12 (85.7%) and in one patient (14.3%) it increased by more than 10%. At the final follow-up, the alveolar and interstitial HRCT scores remained stable in more than 80% of patients, both in patients with and without restrictive lung disease at baseline. Conclusions: Anti-CD20 B cell depletion therapy is effective on skin involvement but seems also to preserve the pulmonary function, as supported by a stable or improved FVC and stable interstitial score, suggesting a possible role of rituximab as a modifying therapy overall in early diffuse SSc.
Inglese
Bosello, S. L., De Luca, G., Rucco, M., Berardi, G., Falcione, M., Danza, F. M., Pirronti, T., Ferraccioli, G., Long-term efficacy of B cell depletion therapy on lung and skin involvement in diffuse systemic sclerosis, <<SEMINARS IN ARTHRITIS AND RHEUMATISM>>, 2015; 44 (4): 428-436. [doi:10.1016/j.semarthrit.2014.09.002] [http://hdl.handle.net/10807/169979]
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