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- Elhai, MParis Descartes University,Carol Davila University of Medicine and Pharmacy (author)
Outcomes of patients with systemic sclerosis treated with rituximab in contemporary practice: a prospective cohort study
- Article/chapterEnglish2019
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- 2019-04-09
- BMJ,2019
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- LIBRIS-ID:oai:prod.swepub.kib.ki.se:141158520
- http://kipublications.ki.se/Default.aspx?queryparsed=id:141158520URI
- https://doi.org/10.1136/annrheumdis-2018-214816DOI
- https://lup.lub.lu.se/record/62df79a8-ffb3-4fc5-8c2e-ef4cf0b28694URI
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- Language:English
- Summary in:English
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- To assess the safety and efficacy of rituximab in systemic sclerosis (SSc) in clinical practice.MethodsWe performed a prospective study including patients with SSc from the European Scleroderma Trials and Research (EUSTAR) network treated with rituximab and matched with untreated patients with SSc. The main outcomes measures were adverse events, skin fibrosis improvement, lung fibrosis worsening and steroids use among propensity score-matched patients treated or not with rituximab.Results254 patients were treated with rituximab, in 58% for lung and in 32% for skin involvement. After a median follow-up of 2 years, about 70% of the patients had no side effect. Comparison of treated patients with 9575 propensity-score matched patients showed that patients treated with rituximab were more likely to have skin fibrosis improvement (22.7 vs 14.03 events per 100 person-years; OR: 2.79 [1.47–5.32]; p=0.002). Treated patients did not have significantly different rates of decrease in forced vital capacity (FVC)>10% (OR: 1.03 [0.55–1.94]; p=0.93) nor in carbon monoxide diffusing capacity (DLCO) decrease. Patients having received rituximab were more prone to stop or decrease steroids (OR: 2.34 [1.56–3.53], p<0.0001). Patients treated concomitantly with mycophenolate mofetil had a trend for better outcomes as compared with patients receiving rituximab alone (delta FVC: 5.22 [0.83–9.62]; p=0.019 as compared with controls vs 3 [0.66–5.35]; p=0.012).ConclusionRituximab use was associated with a good safety profile in this large SSc-cohort. Significant change was observed on skin fibrosis, but not on lung. However, the limitation is the observational design. The potential stabilisation of lung fibrosis by rituximab has to be addressed by a randomised trial.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reumatologi och inflammation hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Rheumatology and Autoimmunity hsv//eng
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
- lung fibrosis
- rituximab
- skin fibrosis
- systemic sclerosis
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- Boubaya, MUniversity of Paris VIII (author)
- Distler, OUniversity Hospital of Zurich (author)
- Smith, VGhent University Hospital (author)
- Matucci-Cerinic, MUniversity of Florence (author)
- Sancho, JJHospital Universitario Doctor Peset (author)
- Truchetet, MECentre Hospitalier Universitaire de Bordeaux (author)
- Braun-Moscovici, YTechnion - Israel Institute of Technology (author)
- Iannone, FUniversity of Bari Aldo Moro (author)
- Novikov, PII.M. Sechenov First Moscow State Medical University (author)
- Lescoat, ARennes University Hospital (author)
- Siegert, ECharité - University Medicine Berlin (author)
- Castellvi, IHospital de Sant Pau (author)
- Airo, PSpedali Civili Di Brescia (author)
- Vettori, SSecond University of Napels (author)
- Langhe, ECatholic University of Leuven (author)
- Hachulla, ELille University Hospital (author)
- Erler, AMedizinsche Klinik und Poliklinik I, Dresden (author)
- Ananieva, LV.A. Nasonova Research Institute of Rheumatology (author)
- Krusche, MAsklepios Klinik Altona (author)
- Lopez-Longo, FJHospital Universitario Quirón (author)
- Distler, JHWFriedrich-Alexander University Erlangen-Nürnberg (author)
- Hunzelmann, NUniversity of Cologne (author)
- Hoffmann-Vold, AMNorwegian Radium Hospital (author)
- Riccieri, VSapienza University of Rome (author)
- Hsu, VMRutgers University: The State University of New Jersey (author)
- Pozzi, MRSan Gerardo Hospital (author)
- Ancuta, CClinical Hospital Dr. Ion Cantacuzino (author)
- Rosato, ESapienza University of Rome (author)
- Mihai, C (author)
- Kuwana, MNippon Medical School (author)
- Saketkoo, LATulane University (author)
- Chizzolini, CGeneva University Hospital (author)
- Hesselstrand, RogerLund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Forskargruppen för systemisk skleros, Lund,Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Systemic Sclerosis Research Group,Lund University Research Groups(Swepub:lu)reum-rhe (author)
- Ullman, SCopenhagen University Hospital (author)
- Yavuz, SMarmara University (author)
- Rednic, SUniversity of Medicine and Pharmacy, Cluj-Napoca (author)
- Caimmi, CUniversity of Verona (author)
- Bloch-Queyrat, C (author)
- Allanore, YParis Descartes University (author)
- Guiducci, S (author)
- Walker, UA (author)
- Kyburz, D (author)
- Lapadula, G (author)
- Maurer, B (author)
- Jordan, S (author)
- Dobrota, R (author)
- Becvar, R (author)
- Sierakowsky, S (author)
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- Sulli, A (author)
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- Vlachoyiannopoulos, PG (author)
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- Czirjak, L (author)
- Varju, C (author)
- Kucharz, EJKarolinska Institutet (author)
- Kotulska, A (author)
- Kopec-Medrek, M (author)
- Widuchowska, M (author)
- Cozzi, F (author)
- Rozman, B (author)
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- Gabrielli, A (author)
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- Mauriziano, O (author)
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- Bohn, JM (author)
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- Bianchi, W (author)
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- Maretti, GB (author)
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- Limonta, M (author)
- Lupi, ALBE (author)
- Lupi, E (author)
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- Rozenbaum, M (author)
- Slobodin, G (author)
- Boulman, N (author)
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- Kahl, S (author)
- Chen, F (author)
- McCloskey, D (author)
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- Moiseev, S (author)
- Paris Descartes UniversityCarol Davila University of Medicine and Pharmacy (creator_code:org_t)
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- In:Annals of the rheumatic diseases: BMJ78:7, s. 979-9871468-20600003-4967
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