AB0879 SAFETY AND EFFECTIVENESS OF RITUXIMAB TREATMENT FOR SYSTEMIC SCLEROSIS: AN UPDATE OF OUR CLINICAL EXPERIENCE Article Swipe
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· 2023
· Open Access
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· DOI: https://doi.org/10.1136/annrheumdis-2023-eular.4389
· OA: W4379650745
<h3>Background</h3> The treatment of systemic sclerosis-SSc is challenging because of its complex pathogenesis. Data on Rituximab-RTX use in SSc are still conflicting but information from case reports or non-randomized clinical trials are somehow promising. <h3>Objectives</h3> According to our previous experience, we newly evaluated the safety and effectiveness of rituximab (RTX) in systemic sclerosis (SSc) patients. In addition, we compared the efficacy of RTX taken alone or in combination with Mycophenolate mofetil (MMF). <h3>Methods</h3> We collected data from 43 SSc subjects referred to the Scleroderma Units of Modena and Reggio Emilia (M/F 10/33, age 54,19±13,75SD years, disease duration 10,5±6,56SD years, lc/dcSSc 19/24). Our patients were treated with RTX (4 weekly/infusions/375 mg/m<sup>2</sup>) between January 2004 and January 2022. The main indications to RTX treatment were: interstitial lung disease, skin fibrosis, and/or articular involvement unresponsive to previous therapies. Clinical information and blood exams were evaluated before (T0), 6 months (T1), and 12 months (T2) after RTX administration. Pulmonary function tests-PFTs, high-resolution computed tomography-HRCT of the lungs, and echocardiogram were performed at T0 and T2. <h3>Results</h3> The extent of skin sclerosis measured by means of modified Rodnan skin score-mRSS decreased from 14,83±10,37SD at T0 to 11,56±7,91SD at T2, and this result was more evident in diffuse cutaneous subsets. Melanodermia and skin tightening significantly improved during follow-up (p<0.0001). Arthritis revealed a good response too leading to a marked reduction of swollen/tender joints (p<0.0001). HAQ and NRS scores also showed a significant amelioration from T0 to T2 (p<0.0001). Inflammatory indices (ESR and CRP) normalized in almost all subjects (p<0.0001). Lung fibrosis at chest-CT remained stable during the entire follow-up. DLCO % improving was more evident in patients with combination RTX+MMF (p<0.0001). No pulmonary arterial hypertension-PAH progression was observed in subjects with a previous diagnosis, while no patient presented a new diagnosis of PAH. No significant side effects were observed. <h3>Conclusion</h3> Our results further support the effectiveness and safety of RTX in the treatment of SSc patients. The improvement of skin sclerosis, arthritis, and pulmonary function were the main results. The role of the association RTX+MMF is intriguing for the preliminary correlations with SSc cardio-pulmonary involvement. Immunomodulatory therapies are successful and encouraging in the management of SSc, and the correct positioning of these drugs is worthy of further investigations. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
