Rituximab for the therapy of systemic sclerosis: a series of 10 cases in a single center

Rev Bras Reumatol Engl Ed. 2016 Sep-Oct;56(5):458-463. doi: 10.1016/j.rbre.2016.06.003. Epub 2016 Jul 22.
[Article in English, Portuguese]

Abstract

Systemic sclerosis (SSc) is a chronic autoimmune disease with a high morbidity and mortality. Although cyclophosphamide is effective for severe and refractory cases, there is demand for new treatments. The biological treatment with B-cell depletion with rituximab (RTX) has demonstrated efficacy for this demand in open-label studies.

Objective: This study was conducted with the aim to retrospectively evaluate all patients who used RTX for the treatment of SSc in our center.

Patients and methods: We retrospectively evaluated medical records of all patients with SSc who used RTX to treat this disease from January 2009 to January 2015. Systemic, cutaneous, and pulmonary involvement data and laboratory results before and six months after the first infusion of RTX were collected.

Results: Ten patients received treatment during the study period and were included in this series. All patients had a diffuse form of the disease. Five patients suffered from an early (duration of disease shorter or equal to four years), rapidly progressive disease, and another five received RTX at late stages of the disease. In both groups of patients, stabilization of the pulmonary picture was observed, with a fall in the skin score in those patients with early forms of the disease.

Discussion: Similar to findings in previous studies, RTX was effective in treating early and rapidly progressive forms of SSc. We also found that patients with long-term illness may benefit from the treatment.

Keywords: Esclerose sistêmica; Escore cutâneo modificado de Rodnan; Fibrose pulmonar; Modified Rodnan skin score; Pulmonary fibrosis; Rituximab; Rituximabe; Systemic sclerosis.

MeSH terms

  • B-Lymphocytes
  • Humans
  • Immunologic Factors / therapeutic use*
  • Lung
  • Retrospective Studies
  • Rituximab / therapeutic use*
  • Scleroderma, Systemic / drug therapy*
  • Treatment Outcome

Substances

  • Immunologic Factors
  • Rituximab