Experience with rituximab in scleroderma: results from a 1-year, proof-of-principle study
Dimitrios Daoussis,Stamatis-Nick C. Liossis,Athanassios C. Tsamandas,Christina Kalogeropoulou,Alexandra Kazantzi,Chaido Sirinian,Maria P. Karampetsou,Georgios Yiannopoulos,Andrew P. Andonopoulos +8 more
Reads0
Chats0
TLDR
The results indicate that RTX may improve lung function in patients with SSc, and it is proposed that larger scale, multicentre studies with longer evaluation periods are needed.Abstract:
Objective. To assess the efficacy of rituximab (RTX) in SSc.
Methods. Fourteen patients with SSc were evaluated. Eight patients were randomized to receive two cycles of RTX at baseline and 24 weeks [each cycle consisted of four weekly RTX infusions (375 mg/m2)] in addition to standard treatment, whereas six patients (control group) received standard treatment alone. Lung involvement was assessed by pulmonary function tests (PFTs) and chest high-resolution CT (HRCT). Skin involvement was assessed both clinically and histologically.
Results. There was a significant increase of forced vital capacity (FVC) in the RTX group compared with baseline (mean ± s.d.: 68.13 ± 19.69 vs 75.63 ± 19.73, at baseline vs 1-year, respectively, P = 0.0018). The median percentage of improvement of FVC in the RTX group was 10.25%, whereas that of deterioration in the controls was 5.04% (P = 0.002). Similarly, diffusing capacity of carbon monoxide (DLCO) increased significantly in the RTX group compared with baseline (mean ± s.d.: 52.25 ± 20.71 vs 62 ± 23.21, at baseline vs 1-year respectively, P = 0.017). The median percentage of improvement of DLCO in the RTX group was 19.46%, whereas that of deterioration in the control group was 7.5% (P = 0.023). Skin thickening, assessed with the Modified Rodnan Skin Score (MRSS), improved significantly in the RTX group compared with the baseline score (mean ± s.d.: 13.5 ± 6.84 vs 8.37 ± 6.45 at baseline vs 1-year, respectively, P < 0.001).
Conclusion. Our results indicate that RTX may improve lung function in patients with SSc. To confirm our encouraging results we propose that larger scale, multicentre studies with longer evaluation periods are needed.read more
Citations
More filters
Journal ArticleDOI
Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group
Suzana Jordan,Jörg H W Distler,Britta Maurer,Dörte Huscher,Jacob M van Laar,Yannick Allanore,Oliver Distler,Tore K Kvien,Paolo Airò,Juan José Alegre Sancho,Lidia Ananjeva,Codrina Michaela Ancuta,Martin Aringer,Alexandra Balbir-Gurman,Francesco Paolo Cantatore,Paola Caramaschi,Emmanuel Chatelus,Veronica Codullo,Dominique Farge-Bancel,Rosario Foti,Armando Gabrielli,Jörg Henes,I. Herrgott,Florenzo Iannone,Francesca Ingegnoli,Esthela Loyo,Marco Matucci-Cerinic,Walid Ahmed Abdel Atty Mohamed,Ulf Müller-Ladner,Øyvind Palm,Sergiu Popa,Gabriela Riemekasten,Simona Rednic,Edoardo Rosato,M. Saracco,Agneta Scheja,Vanessa Smith,Carina Mihai,Gabriela Szucs,Matija Tomšič,Gabriele Valentini,Ulrich A. Walker,Rene Westhovens,Sule Yavuz,Thierry Zenone +44 more
TL;DR: The comparison of RTX treated versus untreated matched-control SSc patients from the EUSTAR cohort demonstrated improvement of skin fibrosis and prevention of worsening lung fibrosis, supporting the therapeutic concept of B cell inhibition in SSc.
Journal ArticleDOI
The Pathogenesis of Systemic Sclerosis
TL;DR: Potential mechanisms underlying the vascular, autoimmune, and fibrotic points of dysregulation in systemic sclerosis are discussed.
Journal ArticleDOI
Scleroderma lung disease
Joshua J. Solomon,Amy L. Olson,Amy L. Olson,Aryeh Fischer,Aryeh Fischer,Todd M. Bull,Todd M. Bull,Kevin K. Brown,Kevin K. Brown,Ganesh Raghu,Ganesh Raghu +10 more
TL;DR: The direct and indirect pulmonary manifestations of SSc are reviewed and recent therapeutic trials that have attempted to target these manifestations are reviewed.
Journal ArticleDOI
Rituximab in severe, treatment-refractory interstitial lung disease.
Gregory J. Keir,Toby M. Maher,Damien Ming,Reza Abdullah,Angelo De Lauretis,Melissa Wickremasinghe,Andrew G. Nicholson,David M. Hansell,Athol U. Wells,Elisabetta A. Renzoni +9 more
TL;DR: In patients with severe interstitial lung disease (ILD) progressing despite conventional immunosuppression, rituximab, a B-lymphocyte depleting monoclonal antibody, may offer an effective rescue therapy as discussed by the authors.
Journal ArticleDOI
Cellular interactions in the pathogenesis of interstitial lung diseases
Gianluca Bagnato,Sergio Harari +1 more
TL;DR: The pathogenic mechanisms by cell of interest are analyzed, comparing the role of cell subsets in the pathogenesis of IPF and systemic sclerosis and new insights into the complex cellular contributions and interactions will be provided.
References
More filters
Journal ArticleDOI
Preliminary criteria for the classification of systemic sclerosis (scleroderma)
TL;DR: A multicenter, ongoing study of early-diagnosed cases of systemic sclerosis and comparison patients with systemic lupus erythematosus, polymyositis/dermatomyositis, and Raynaud's phenomenon was conducted in order to develop classification criteria for systemic sclerosis.
Journal Article
Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee.
C Leroy,Roy D. Altman,J.B. Kirsner,Jonathan A. Myers,Dennis J. McShane,D. Masi,Gordon C. Sharp,Gerald P. Rodnan,A. MacKenzie-Graham,Thomas A. Medsger,James F. Fries +10 more
TL;DR: Proposed classification criteria for systemic sclerosis had a 97% sensitivity for definite systemic sclerosis and 98% specificity when applied to the case and comparison patients included in this study.
Journal ArticleDOI
Cyclophosphamide versus placebo in scleroderma lung disease.
Donald P. Tashkin,Robert Elashoff,Philip J. Clements,Jonathan G. Goldin,Michael D. Roth,Daniel E. Furst,Edgar Arriola,Richard M. Silver,Charlie Strange,Marcy B. Bolster,James R. Seibold,David J. Riley,Vivien Hsu,John Varga,Dean E. Schraufnagel,Arthur C. Theodore,Robert W. Simms,Robert A. Wise,Fredrick M. Wigley,Barbara White,Virginia D. Steen,Charles A. Read,Maureen D. Mayes,Ed Parsley,Kamal K. Mubarak,M. Kari Connolly,Jeffrey A. Golden,Mitchell A. Olman,B. J. Fessler,Naomi F. Rothfield,Mark L. Metersky +30 more
TL;DR: One year of oral cyclophosphamide in patients with symptomatic scleroderma-related interstitial lung disease had a significant but modest beneficial effect on lung function, dyspnea, thickening of the skin, and the health-related quality of life.
Journal ArticleDOI
Chronic graft-versus-host disease.
TL;DR: Chronic graft versus host disease (GvHD) continues to be a significant problem in the allogeneic stem cell transplant setting and, as the authors continue to use alternative stem cell sources and attempt to modulate the immune system to increase an anti-tumour effect, they will probably see rising numbers of patients with this complication.
Journal ArticleDOI
A multicenter, prospective, randomized, double-blind, placebo-controlled trial of corticosteroids and intravenous cyclophosphamide followed by oral azathioprine for the treatment of pulmonary fibrosis in scleroderma.
Rachel K. Hoyles,Ross W Ellis,Jessica Wellsbury,Belinda Lees,Pauline Newlands,Nicole S. L. Goh,Chris Roberts,Sujal R. Desai,Ariane L. Herrick,Neil McHugh,Noeleen M Foley,Stanley B. Pearson,Paul Emery,Douglas J. Veale,Christopher P. Denton,Athol U. Wells,Carol M. Black,Roland M. du Bois +17 more
TL;DR: It is suggested that treatment of pulmonary fibrosis in SSc with low-dose prednisolone and IV CYC followed by AZA stabilizes lung function in a subset of patients with the disease.
Related Papers (5)
Cyclophosphamide versus placebo in scleroderma lung disease.
Donald P. Tashkin,Robert Elashoff,Philip J. Clements,Jonathan G. Goldin,Michael D. Roth,Daniel E. Furst,Edgar Arriola,Richard M. Silver,Charlie Strange,Marcy B. Bolster,James R. Seibold,David J. Riley,Vivien Hsu,John Varga,Dean E. Schraufnagel,Arthur C. Theodore,Robert W. Simms,Robert A. Wise,Fredrick M. Wigley,Barbara White,Virginia D. Steen,Charles A. Read,Maureen D. Mayes,Ed Parsley,Kamal K. Mubarak,M. Kari Connolly,Jeffrey A. Golden,Mitchell A. Olman,B. J. Fessler,Naomi F. Rothfield,Mark L. Metersky +30 more
A multicenter, prospective, randomized, double-blind, placebo-controlled trial of corticosteroids and intravenous cyclophosphamide followed by oral azathioprine for the treatment of pulmonary fibrosis in scleroderma.
Interstitial lung disease in systemic sclerosis: a simple staging system.
Mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II): a randomised controlled, double-blind, parallel group trial
Donald P. Tashkin,Michael D. Roth,Philip J. Clements,Daniel E. Furst,Dinesh Khanna,Eric C. Kleerup,Jonathan G. Goldin,Edgar Arriola,Elizabeth R. Volkmann,Suzanne Kafaja,Richard M. Silver,Virginia D. Steen,Charlie Strange,Robert A. Wise,Fredrick M. Wigley,Maureen D. Mayes,David J. Riley,Sabiha Hussain,Shervin Assassi,Vivien Hsu,Bela Patel,Kristine Phillips,Fernando J. Martinez,Jeffrey A. Golden,M. Kari Connolly,John Varga,Jane Dematte,Monique Hinchcliff,Aryeh Fischer,Jeffrey J. Swigris,Richard T. Meehan,Arthur C. Theodore,Robert W. Simms,Suncica Volkov,Dean E. Schraufnagel,Mary Beth Scholand,Tracy M. Frech,Jerry A. Molitor,Kristin B. Highland,Charles A. Read,Marvin J. Fritzler,Grace Kim,Chi-Hong Tseng,Robert Elashoff +43 more
Autologous Hematopoietic Stem Cell Transplantation vs Intravenous Pulse Cyclophosphamide in Diffuse Cutaneous Systemic Sclerosis: A Randomized Clinical Trial
J.M. van Laar,Dominique Farge,Jacob K. Sont,Kamran Naraghi,Zora Marjanovic,Jérôme Larghero,Annemie J. Schuerwegh,Erik W.A. Marijt,Madelon C. Vonk,Anton Schattenberg,Marco Matucci-Cerinic,A E Voskuyl,A.A. van de Loosdrecht,Thomas Daikeler,Ina Kötter,Marc Schmalzing,Thierry Martin,Bruno Lioure,S.M. Weiner,Alexander Kreuter,Christophe Deligny,Jean-Marc Durand,Paul Emery,Klaus P Machold,F. Sarrot-Reynauld,Klaus Warnatz,Daniel Adoue,Joël Constans,Hans-Peter Tony,N. Del Papa,A Fassas,Andrea Himsel,David Launay,A. Lo Monaco,P. Philippe,Isabelle Quéré,E. Rich,Rene Westhovens,Bridget Griffiths,Riccardo Saccardi,F.H.J. van den Hoogen,Willem E. Fibbe,Gérard Socié,Alois Gratwohl,Alan Tyndall +44 more