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Potential efficacy of T and B lymphocyte-targeted therapies on articular involvement of patients with rheumatoid arthritis and systemic sclerosis overlap syndrome. Results from a 2-centre series of 22 cases


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11

 

  1. Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France.
  2. Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
  3. Department of Biomedical Informatics, Rouen University, CHU de Rouen, and LIMICS U1142, Sorbonne University, Paris, France.
  4. Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France.
  5. Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
  6. Department of Internal Medicine, Normandie Univ, UNICAEN, CHU de Caen, France.
  7. Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
  8. Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
  9. Department of Rheumatology, Normandie Univ, UNICAEN, CHU de Caen, France.
  10. Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France.
  11. Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France. vittecoq.olivier@wanadoo.fr

CER16848
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PMID: 38489323 [PubMed]

Received: 21/05/2023
Accepted : 28/08/2023
In Press: 13/03/2024

Abstract

OBJECTIVES:
To analyse in routine practice the efficacy of targeted therapies on joint involvement of patients with rheumatoid arthritis/systemic sclerosis (RA/SSc) overlap syndrome.
METHODS:
This was a retrospective analysis of medical records of two academic centres over a 10-year period. Joint response to targeted therapies was measured according to EULAR criteria based on Disease Activity Score (DAS)-28. In addition, changes in CRP level and glucocorticoid consumption were recorded.
RESULTS:
Nineteen patients were included. Methotrexate (n=11) and hydroxychloroquine (n=4) were the most used first-line treatments. Targeted therapies were frequently used (n=14). Tocilizumab was the most selected therapy (n=8), then rituximab (n=5), abatacept and anti-tumour necrosis factor (n=4). Twenty-one treatment sequences were assessed, including 18 with EULAR response criteria. Responses were “good” or “moderate” in 100% (4/4) of patients treated with abatacept, 80% (4/5) with rituximab, 40% (2/5) with tocilizumab, and 25% (1/4) with anti-TNF. T and B lymphocyte-targeted therapies (abatacept, rituximab) resulted more frequently in a “good” or “moderate” response compared to cytokine inhibitors (tocilizumab, etanercept, infliximab) with a significant decrease in DAS-28 at 6 months (-1.75; p=0.016) and a trend to a lower consumption of glucocorticoids. C
CONCLUSIONS:
In patients with RA/SSc overlap syndrome refractory to conventional synthetic-DMARDs, T and B lymphocyte-targeted therapies seem to be a promising therapeutic option to control joint activity.

DOI: https://doi.org/10.55563/clinexprheumatol/0znf7e

Rheumatology Article