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Treatment

 

Combination therapy with rituximab and mycophenolate mofetil in systemic sclerosis. A single-centre case series study

1, 2, 3, 4, 5, 6, 7

 

  1. Clinica Medica, Department of Internal Medicine, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy. paolo.fraticelli@ospedaliriuniti.marche.it
  2. Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.
  3. Clinica Reumatologica, Ospedale C. Urbani di Jesi, Università Politecnica delle Marche, Ancona, Italy.
  4. Radiologia, Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona.
  5. Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.
  6. Clinica Medica, Department of Internal Medicine, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
  7. Clinica Medica, Department of Internal Medicine, and Department of Clinical and Molecular Sciences, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.

CER11343
2018 Vol.36, N°4 ,Suppl.113
PI 0142, PF 0145
Treatment

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PMID: 30277864 [PubMed]

Received: 20/04/2018
Accepted : 02/07/2018
In Press: 30/09/2018
Published: 30/09/2018

Abstract

OBJECTIVES:
To describe a single centre experience using combination therapy with rituximab (RTX) and mycophenolate mofetil (MMF) in a prospective series of systemic sclerosis (SSc) patients with pulmonary and cutaneous involvement, rapidly progressive or resistant to conventional therapy.
METHODS:
RTX was administered in two different regimens (1000 mg fortnightly x 2 or 375 mg/m2/week for 4 consecutive weeks) at baseline and after 6 months, associated with MMF 2000 mg/day continuously. Cutaneous fibrosis was evaluated assessing modified Rodnan Skin Score (mRSS) and pulmonary involvement was evaluated performing pulmonary function tests, diffusing lung capacity for carbon monoxide and chest high-resolution computed tomography (HRCT). The radiological extension of the interstitial lung disease (ILD) at HRCT, was assessed with the conventional visual reader-based score (CoVR) and with a computerised-aided method (CaM) using a DICOM soft- ware.
RESULTS:
Eighteen SSc patients underwent combination therapy (F/M: 10/8, median age 51 years, median duration of disease 27 months). Data from fifteen patients were available at 12-month follow-up. The mRSS showed a significant improvement; a significant increase in forced vital capacity and forced expiratory volume in the first second were also observed. In addition, a signi cant reduction of the extension of ILD was detected when evaluated with CaM. No serious adverse events were observed during the follow-up period.
CONCLUSIONS:
Despite preliminary results and limited to a small number of patients, our data suggest that therapy with RTX and MMF is well tolerated, safe, and potentially effective for cutaneous and pulmonary involvement in SSc.

Rheumatology Article