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 originale | Inglese |
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pagine (da-a) | 428-436 |
Numero di pagine | 9 |
Rivista | Seminars in Arthritis and Rheumatism |
Volume | 44 |
Numero di pubblicazione | 4 |
DOI | |
Stato di pubblicazione | Pubblicato - 2015 |
All Science Journal Classification (ASJC) codes
- Reumatologia
- Anestesiologia e Medicina del Dolore
Keywords
- Adult
- Antibodies
- Antigens
- B cells
- B-Lymphocytes
- CD20
- CD20 depletion therapy
- Cyclophosphamide
- Female
- Follow-Up Studies
- Humans
- Lung
- Lung involvement
- Male
- Middle Aged
- Monoclonal
- Murine-Derived
- Respiratory Function Tests
- Rituximab
- Scleroderma
- Severity of Illness Index
- Skin
- Skin fibrosis
- Systemic
- Systemic sclerosis
- Time Factors
- Tomography
- Treatment Outcome
- X-Ray Computed