Rituximab Treatment may significantly improve skin and lung fibrosis in Systemic Sclerosis

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