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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 19 cases
N. Lebel1, I. Marie2, J. Grosjean3, P. Brevet4, M. Leclercq5, A. Dumont6, H. Levesque7, Y. Benhamou8, C. Marcelli9, T. Lequerre10, O. Vittecoq11
- Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France.
- Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
- Department of Biomedical Informatics, Rouen University, CHU de Rouen, and LIMICS U1142, Sorbonne University, Paris, France.
- Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France.
- Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
- Department of Internal Medicine, Normandie Univ, UNICAEN, CHU de Caen, France.
- Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
- Department of Internal Medicine, Rouen University, CHU de Rouen, and Inserm 1234, Rouen, France.
- Department of Rheumatology, Normandie Univ, UNICAEN, CHU de Caen, France.
- Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France.
- Department of Rheumatology, Rouen University, CHU de Rouen, and CIC-CRB 1404, Inserm 1234, Rouen, France. vittecoq.olivier@wanadoo.fr
CER16848
2024 Vol.42, N°8
PI 1536, PF 1540
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PMID: 38489323 [PubMed]
Received: 21/05/2023
Accepted : 28/08/2023
In Press: 13/03/2024
Published: 13/08/2024
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.
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.
