Efficacy and safety of rituximab therapy in patients with systemic sclerosis disease (SSc): systematic review and meta-analysis

Moradzadeh, Maliheh; Aghaei, Mehrdad; Mehrbakhsh, Zahra; Arab‐Bafrani, Zahra; Abdollahi, Nafiseh

doi:10.1007/s10067-021-05698-4

Cited by 23 publications

(14 citation statements)

References 44 publications

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“…Полученные результаты дополняют и расширяют материалы наших предыдущих исследований [25,26] и исследований других авторов [27,28,[36][37][38], свидетельствующих об эффективности РТМ в отношении общей активности ССД, фиброза кожи и легких. Особый интерес представляют данные о снижении уровня анти-Топо 1 и более высокой эффективности РТМ у пациентов с анти-Топо 1-позитивным субтипом ССД.…”

Section: Discussionunclassified

“…Перспективное направление лечения ССД связано с анти-В-клеточной терапией ритуксимабом (РТМ), представляющим собой химерные моноклональные антитела к CD20 В-лимфоцитов [22,23]. Клиническая эффективность РТМ при ССД продемонстрирована в многочисленных исследованиях [24][25][26][27][28][29]. При этом предварительные результаты свидетельствуют о том, что снижение титров АНФ на фоне лечения РТМ у пациентов с ССД, ассоциируется с положительной динамикой кожного счета [30,31], а у пациентов с ССД, в сыворотках которых исходно выявлялись анти-Топо 1, эффективность терапии РТМ выше, чем циклофосфамидом [32].…”

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Anti-topoisomerase 1 antibody level changes after B сell depletion therapy in systemic sclerosis

Ananieva¹,

Garzanova²,

Koneva³

et al. 2022

Naučno-praktičeskaâ revmatologiâ

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The aim of our study was to assess the relationship between the changes of antinuclear autoantibodies (ANA) and autoantibodies to topoisomerase 1 (anti-Topo 1) in systemic sclerosis (SSc) patients on rituximab (RTX) therapy.Materials and methods. The prospective study included 88 patients (73 women) with a mean age of 47 (17– 71) years. The mean disease duration was 5.9±4.8 years. The mean follow-up period was more than 2 years (27 (12–42) months).Results. We documented a statistically significant change in skin score, the disease activity index, improvement of pulmonary function and reduction of mean dose of prednisolone after RTX treatment. There was a significant decrease in the number of patients with high levels of ANA and overall decrease of the ANA and anti-Topo 1 levels. A moderate positive statistically significant correlation was found between ANA and anti-Topo 1 (r=0.403). In the group of patients positive for anti-Topo 1 there were a more pronounced depletion of B lymphocytes, significantly higher increase in forced vital capacity and diffusion capacity, decrease in the disease activity index, compared with a patients negative for anti-Topo 1.Conclusions. We observed the decline in the level of ANA and anti-Topo 1 in SSc patients after RTX therapy and it was correlated by an improvement of the main outcome parameters of the disease. Therefore, anti-Topo 1 positivity could be considered as a predictor of a better response to RTX treatment, especially in SSc patients with hyperproduction of anti-Topo 1.

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Section: Discussionunclassified

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Anti-topoisomerase 1 antibody level changes after B сell depletion therapy in systemic sclerosis

Ananieva¹,

Garzanova²,

Koneva³

et al. 2022

Naučno-praktičeskaâ revmatologiâ

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“…Several reviews with meta-analyses have been published recently regarding the efficacy of RTX in SSc (103)(104)(105)(106)(107)(108). These reviews have differences concerning study inclusion criteria and all suffer from the paucity of high-powered randomized studies.…”

Section: B Cells Can Interact With Other Cell Types and Promote Fibrosismentioning

confidence: 99%

Pathogenetic Aspects of Systemic Sclerosis: A View Through the Prism of B Cells

et al. 2022

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Systemic sclerosis (SSc) is a rare fibrotic rheumatic disease, associated with psychological distress and increased morbidity and mortality due to skin involvement and internal organ damage. The current understanding of the complex pathogenesis is yet incomplete and disease therapeutic algorithms are far from optimal. Immunologic aberrations are considered key factors for the disease, along with vascular involvement and excess fibrosis. Adaptive immunity and its specialized responses are an attractive research target and both T and B cells have been extensively studied in recent years. In the present review, the focus is placed on B cells in SSc. B cell homeostasis is deranged and B cell subsets exhibit an activated phenotype and abnormal receptor signaling. Autoantibodies are a hallmark of the disease and the current perception of their diagnostic and pathogenetic role is analyzed. In addition, B cell cytokine release and its effect on immunity and fibrosis are examined, together with B cell tissue infiltration of the skin and lung. These data support the concept of targeting B cells as part of the therapeutic plan for SSc through well designed clinical trials.

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“…Not only the DESIRES trial, but also meta-analyses integrating clinical trials containing non-Asian patients have reported improvement in mRSS with rituximab treatment [ 61 , 62 , 63 ]. It is hoped that the efficacy of rituximab in fibrotic involvement of SSc will be tested in future double-blind, placebo-controlled, and randomized controlled trials that include SSc patients from multiple ethnic groups.…”

Section: Rituximabmentioning

confidence: 99%

New Era in Systemic Sclerosis Treatment: Recently Approved Therapeutics

Ebata

Yoshizaki‐Ogawa²,

Sato³

et al. 2022

JCM

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Systemic sclerosis (SSc) is a chronic autoimmune disease with a poor prognosis. Among the various complications of SSc, treatment options for the fibrotic lesions, skin sclerosis, and SSc-associated interstitial lung disease (SSc-ILD) have been limited. However, since 2019, the efficacy and safety of nintedanib, tocilizumab, and rituximab for SSc or SSc-ILD have been demonstrated in double-blind, randomized, placebo-controlled trials, respectively. The antifibrotic agent nintedanib was approved for SSc-ILD in all regions of the United States, Europe, and Japan after the SENSCIS study confirmed that it suppressed the reduction in forced vital capacity (FVC), a measure of SSc-ILD. Tocilizumab, an anti-interleukin-6 receptor antibody, was approved for the treatment of SSc-ILD in the United States after the FocuSSced study showed that it inhibited the decrease in FVC. Rituximab, an anti-CD20 antibody, showed improvement in both modified Rodnan skin score, a measure of skin sclerosis, and FVC in the DESIRES study, and was approved in Japan for the treatment of SSc itself. With the development of these three drugs, SSc treatment is entering a new era. This paper outlines the latest advances in SSc therapeutics, focusing on nintedanib, tocilizumab, and rituximab.

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Efficacy and safety of rituximab therapy in patients with systemic sclerosis disease (SSc): systematic review and meta-analysis

Cited by 23 publications

References 44 publications

Anti-topoisomerase 1 antibody level changes after B сell depletion therapy in systemic sclerosis

Anti-topoisomerase 1 antibody level changes after B сell depletion therapy in systemic sclerosis

Pathogenetic Aspects of Systemic Sclerosis: A View Through the Prism of B Cells

New Era in Systemic Sclerosis Treatment: Recently Approved Therapeutics

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