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

Silvia Laura Bosello, Giacomo De Luca, Manuela Rucco, Giorgia Berardi, Matteo Falcione, Francesco Maria Danza, Tommaso Pirronti, Gianfranco Ferraccioli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

95 Citazioni (Scopus)

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.
Lingua originaleEnglish
pagine (da-a)428-436
Numero di pagine9
RivistaSeminars in Arthritis and Rheumatism
Volume44
DOI
Stato di pubblicazionePubblicato - 2015

Keywords

  • Adult
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20
  • B cells
  • B-Lymphocytes
  • CD20 depletion therapy
  • Cyclophosphamide
  • Female
  • Follow-Up Studies
  • Humans
  • Lung
  • Lung involvement
  • Male
  • Middle Aged
  • Respiratory Function Tests
  • Rituximab
  • Scleroderma, Systemic
  • Severity of Illness Index
  • Skin
  • Skin fibrosis
  • Systemic sclerosis
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

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