Rheumatology Medical News about diffuse cutaneous systemic sclerosis;rituximab

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B cell depletion with rituximab in patients with diffuse cutaneous systemic sclerosis
Arthritis & Rheumatism, 02/02/09

Lafyatis R et al. – Treatment with rituximab in diffuse cutaneous systemic sclerosis (dcSSC) pts was safe and well tolerated; treatment resulted in both depletion of circulating B cells and depletion of dermal B cells; had little effect on the levels of SSc-associated autoantibodies. Rituximab treatment had no beneficial effect on skin disease; its potential efficacy in other organs such as lungs could not be clearly evaluated in this small open-label trial.

Methods

Aim was to determine the safety, and efficacy of rituximab on autoimmunity and fibrosis in pts with dcSSc
15 pts; received 2 iv doses of rituximab (1,000 mg), administered 2 wks apart
Safety, clinical, and exploratory outcomes were evaluated at baseline and at 6 mo
Primary outcome was change in the modified Rodnan skin thickness score (MRSS) at 6 mo

Results

AEs: frequent infusion reactions and rare infections
Mean change in the MRSS between baseline and 6 mo was not significant
Results of pulmonary function tests and other measures of major organ involvement were stable
The modest B cell infiltrates at baseline were completely depleted at 6 mo in most pts
Autoantibody titers showed only modest and variable changes after treatment

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