Dimitrios Daoussis1, Konstantinos Melissaropoulos2, Georgios Sakellaropoulos3, Ioannis Antonopoulos2, Theodora E Markatseli4, Theodora Simopoulou5, Panagiotis Georgiou6, Andrew P Andonopoulos2, Alexandros A Drosos4, Lazaros Sakkas5, Stamatis-Nick Liossis2. 1. Division of Rheumatology, Department of Internal Medicine, Patras University Hospital, University of Patras Medical School, 26504 Rion, Patras, Greece. Electronic address: jimdaoussis@hotmail.com. 2. Division of Rheumatology, Department of Internal Medicine, Patras University Hospital, University of Patras Medical School, 26504 Rion, Patras, Greece. 3. Department of Medical Physics, University of Patras, Patras, Greece. 4. Department of Rheumatology, Ioannina University Hospital, University of Ioannina Medical School, Ioannina, Greece. 5. Department of Rheumatology, Larissa University Hospital, University of Thessaly Medical School, Larissa, Greece. 6. Department of Rheumatology, Agios Andreas District Hospital, Patras, Greece.
Abstract
OBJECTIVES: Rituximab (RTX) may favorably affect lung function and skin fibrosis in patients with systemic sclerosis (SSc). We aimed to assess long-term efficacy and safety of RTX in SSc compared to standard treatment. METHODS: A total of 51 patients with SSc-associated interstitial lung disease were recruited and treated with RTX (n = 33) or conventional treatment (n = 18). Median follow-up was 4 years (range: 1-7). Conventional treatment consisted of azathioprine (n = 2), methotrexate (n = 6), and mycophenolate mofetil (n = 10). RESULTS: Patients in the RTX group showed an increase in FVC at 2 years (mean ± SD of FVC: 80.60 ± 21.21 vs 86.90 ± 20.56 at baseline vs 2 years, respectively, p = 0.041 compared to baseline). In sharp contrast, patients in the control group had no change in FVC during the first 2 years of follow-up. At the 7 year time point the remaining patients in the RTX group (n = 5) had higher FVC compared to baseline (mean ± SD of FVC: 91.60 ± 14.81, p = 0.158 compared to baseline) in contrast to patients in the control group (n = 9) where FVC deteriorated (p < 0.01, compared to baseline). Direct comparison between the 2 groups showed a significant benefit for the RTX group in FVC (p = 0.013). Improvement of skin thickening was found in both the RTX and the standard treatment group; however, direct comparison between groups strongly favored RTX at all-time points. Adverse events were comparable between groups. CONCLUSIONS: Our data indicate that RTX has a beneficial effect on lung function and skin fibrosis in patients with SSc. Randomized controlled studies are highly needed.
OBJECTIVES:Rituximab (RTX) may favorably affect lung function and skin fibrosis in patients with systemic sclerosis (SSc). We aimed to assess long-term efficacy and safety of RTX in SSc compared to standard treatment. METHODS: A total of 51 patients with SSc-associated interstitial lung disease were recruited and treated with RTX (n = 33) or conventional treatment (n = 18). Median follow-up was 4 years (range: 1-7). Conventional treatment consisted of azathioprine (n = 2), methotrexate (n = 6), and mycophenolate mofetil (n = 10). RESULTS:Patients in the RTX group showed an increase in FVC at 2 years (mean ± SD of FVC: 80.60 ± 21.21 vs 86.90 ± 20.56 at baseline vs 2 years, respectively, p = 0.041 compared to baseline). In sharp contrast, patients in the control group had no change in FVC during the first 2 years of follow-up. At the 7 year time point the remaining patients in the RTX group (n = 5) had higher FVC compared to baseline (mean ± SD of FVC: 91.60 ± 14.81, p = 0.158 compared to baseline) in contrast to patients in the control group (n = 9) where FVC deteriorated (p < 0.01, compared to baseline). Direct comparison between the 2 groups showed a significant benefit for the RTX group in FVC (p = 0.013). Improvement of skin thickening was found in both the RTX and the standard treatment group; however, direct comparison between groups strongly favored RTX at all-time points. Adverse events were comparable between groups. CONCLUSIONS: Our data indicate that RTX has a beneficial effect on lung function and skin fibrosis in patients with SSc. Randomized controlled studies are highly needed.
Authors: Ioannis Antonopoulos; Dimitrios Daoussis; Maria-Eleni Lalioti; Theodora E Markatseli; Alexandros A Drosos; Stavros Taraviras; Andrew P Andonopoulos; Stamatis-Nick C Liossis Journal: Rheumatol Int Date: 2019-06-21 Impact factor: 2.631
Authors: Christina G Katsiari; Theodora Simopoulou; Ioannis Alexiou; Lazaros I Sakkas Journal: Hum Vaccin Immunother Date: 2018-07-16 Impact factor: 3.452
Authors: Alejandro Robles-Perez; Jordi Dorca; Ivan Castellví; Joan Miquel Nolla; Maria Molina-Molina; Javier Narváez Journal: Rheumatol Int Date: 2020-03-10 Impact factor: 2.631