Rituximab Treatment in Systemic Sclerosis

Rituximab Treatment may significantly improve skin and lung fibrosis in Systemic Sclerosis suggests a new study published in the JAMA Dermatology.

Rituximab is emerging as a promising therapeutic option for systemic sclerosis (SSc), but its long-term outcomes and response markers are unknown.

A study was done to evaluate the long-term outcomes after rituximab treatment for SSc and identify potential response markers.

In this single-center cohort study, patients with SSc who continued to receive rituximab after the DESIRES trial were analyzed with a median follow-up of 96 weeks. Among the 43 patients who completed the DESIRES trial, 31 continued to receive rituximab, of which 29 with complete data were included in this study. A post hoc analysis of the clinical and laboratory data was conducted.

Results

In 29 patients with SSc (27 female [93%]; median [IQR] age, 48 [35-45] years), significant improvement in modified Rodnan skin score (MRSS) and percentage of predicted forced vital capacity (FVC%) were observed after 1 and 3 courses of rituximab, respectively, both of which were sustained during follow-up.

• High responders experienced a greater decrease in serum levels of IgG and IgA compared with low responders.
• In particular, decrease in serum IgA levels significantly correlated with the improvement in MRSS.
• At the last follow-up, low IgM, low IgA, and low IgG was observed in 7, 1, and 1 patient, respectively, of which low IgM was associated with greater improvement in FVC% predicted.

In this cohort study, rituximab treatment was associated with significantly improved skin and lung fibrosis in SSc in a long-term follow-up. Decrease in serum immunoglobulins was associated with greater clinical response.

Reference

Kuzumi A, Ebata S, Fukasawa T, et al. Long-term Outcomes After Rituximab Treatment for Patients With Systemic Sclerosis: Follow-up of the DESIRES Trial With a Focus on Serum Immunoglobulin Levels. JAMA Dermatol. Published online February 15, 2023. doi:10.1001/jamadermatol.2022.6340

Keywords

Rituximab, Treatment, significantly, improve, skin, lung fibrosis, Systemic Sclerosis, Kuzumi A, Ebata S, Fukasawa T, JAMA Dermatology