Tocilizumab for systemic sclerosis with cardiac involvement: a case report

Lee, Zheng Cong; Noviani, Maria; Yap, Jonathan; Chin, Calvin Woon Loong; Ng, Sue‐Ann; Low, Andrea

doi:10.55563/clinexprheumatol/cibdmf

Cited by 2 publications

(4 citation statements)

References 13 publications

(14 reference statements)

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“… Case series Lee et al . [ 45 , 46 ] 2 CMR (LGE areas, elevated native T1 values and ECV). CMR indices improvement, LVEF improvement Case report Ishizaki et al .…”

Section: Drugs Targeting Myocardial Inflammationmentioning

confidence: 99%

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Therapeutic strategies for primary heart involvement in systemic sclerosis

Batani,

Dagna,

De Luca

2024

Rheumatology and Immunology Research

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Primary heart involvement (pHI) is frequent in systemic sclerosis (SSc), even though often underdiagnosed. SSc-pHI has been recently defined as cardiac abnormalities that are predominantly attributable to SSc rather than other causes and/or complications. SSc-pHI represents a major determinant of mortality in SSc, accounting alone for about 12% of disease-related deaths; its early recognition and promptly therapeutic interventions are therefore crucial. Both perfusion defects and myocardial inflammation contribute to the occurrence of myocardial fibrosis that precipitates myocardial remodeling, potentially leading to heart failure and arrhythmic complications. To date, clear evidence and guidelines for effectively managing SSc pHI are not established yet, resulting in a lack of a defined therapeutic algorithm. In this review we summarize the most recent scientific literature on the prevailing therapeutic strategies and interventions to manage SSc-pHI, with particular focus on therapeutic strategies to counteract the 3 major pathogenic events of the disease, i.e. microvascular damage, myocardial inflammation and myocardial fibrosis.

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“… Case series Lee et al . [ 45 , 46 ] 2 CMR (LGE areas, elevated native T1 values and ECV). CMR indices improvement, LVEF improvement Case report Ishizaki et al .…”

Section: Drugs Targeting Myocardial Inflammationmentioning

confidence: 99%

“…Following this initial case, tocilizumab was administered in another four cases of SSc-myocarditis, with significant results in three out of four cases in terms of CMR features and contractile function. [ 23 , 45 , 46 ]…”

Section: Drugs Targeting Myocardial Inflammationmentioning

confidence: 99%

Therapeutic strategies for primary heart involvement in systemic sclerosis

Batani,

Dagna,

De Luca

2024

Rheumatology and Immunology Research

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“…Taken together, this further highlights the utility of BNP and NT-proBNP as prognostic markers for SSc cardiac involvement. Levels of NT-ProBNP also fall following treatment, [ 17 ] which demonstrates its utility to monitor treatment response. Data on the correlation of BNP or NT-proBNP to severity on cardiac imaging has not been consistent, [ 18 ] with further studies needed.…”

Section: B-type Natriuretic Peptide: Marker Of Elevated Cardiac Wall ...mentioning

confidence: 99%

“…[ 27 ] Two case reports focusing on the role of tocilizumab in the treatment of SSc cardiac complications demonstrated improvement in NT-proBNP and troponin levels, left and right ventricular ejection fractions and imaging parameters on cMRI following treatment (improvement in native T1 and stabilization/improvement in extracellular volume fraction). [ 17 , 28 ] Taken together, IL-6 may be a predictive and prognostic biomarker, and also represents a novel therapeutic target for SSc cardiac involvement. Further studies would be beneficial to elucidate if IL-6 could also be a diagnostic marker for cardiac involvement in SSc.…”

Section: Pro-inflammatory Cytokines: Marker Of Inflammationmentioning

confidence: 99%

Biomarkers in the evaluation of cardiac involvement in systemic sclerosis

Masri,

Ng,

Chin

et al. 2024

Rheumatology and Immunology Research

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Systemic sclerosis is a multisystemic disease for which the heart can be affected leading to cardiac complications and mortality. Up to 80% of patients with systemic sclerosis have cardiac involvement with varying levels of severity. Several molecules have been identified that can be used as markers of cardiac involvement. These biomarkers can arise directly from the heart due to cardiac damage from the disease such as cardiac troponins or from the underlying dysregulated immune process itself such as the proinflammatory cytokines including interleukin (IL)-6. This review aims to summarize the evidence on currently known biomarkers that are can be diagnostic, prognostic or predictive of primary cardiac involvement in systemic sclerosis. We also highlight potential new biomarkers based on the current understanding of the disease process. Clinical use of these markers can benefit patients through earlier identification of those with cardiac involvement, many of whom can be asymptomatic in the early stage, with higher risk of complications, with the overall goal to improve outcomes of these affected patients.

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Tocilizumab for systemic sclerosis with cardiac involvement: a case report

Cited by 2 publications

References 13 publications

Therapeutic strategies for primary heart involvement in systemic sclerosis

Therapeutic strategies for primary heart involvement in systemic sclerosis

Biomarkers in the evaluation of cardiac involvement in systemic sclerosis

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