title: Effect of long-term treatment with rituximab on pulmonary function and skin fibrosis in patients with diffuse systemic sclerosis.
abstract: OBJECTIVE
  To assess the safety and efficacy of long-term treatment with rituximab (RTX) in patients with systemic sclerosis (SSc).
  
  
  METHODS
  Eight patients with SSc-associated interstitial lung disease (ILD) received 4 cycles of RTX and had a follow-up of 2 years. Lung involvement was assessed by pulmonary function tests and chest HRCT. Skin involvement was assessed both clinically and histologically.
  
  
  RESULTS
  We found a linear improvement of lung function and skin thickening over the 2 years of RTX treatment. There was a significant increase of FVC at 2 years compared to baseline (mean ± SEM: 77.13±7.13 vs. 68.13±6.96, respectively, p<0.0001). Similarly, DLco increased significantly at 2 years compared to baseline (mean ± SEM: 63.13±7.65 vs. 52.25±7.32, respectively, p<0.001). Skin thickening, assessed with the MRSS, improved significantly at 2 years compared to baseline (mean ± SEM: 4.87±0.83 vs. 13.5±2.42, respectively, p<0.0001). A reduction in myofibroblast score was seen histologically following RTX treatment.
  
  
  CONCLUSIONS
  Our results indicate that long-term treatment with RTX may favourably affect lung function and skin fibrosis in patients with SSc. Larger scale, multicentre, randomised, controlled studies are needed to further explore the efficacy of RTX in SSc.
authors.affiliation: Department of Internal Medicine, University of Patras Medical School, Patras, Greece. jimdaoussis@hotmail.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Daoussis
authors.forename: Stamatis-Nick C
authors.initials: SN
authors.lastname: Liossis
authors.forename: Athanassios C
authors.initials: AC
authors.lastname: Tsamandas
authors.forename: Christina
authors.initials: C
authors.lastname: Kalogeropoulou
authors.forename: Fotini
authors.initials: F
authors.lastname: Paliogianni
authors.forename: Chaido
authors.initials: C
authors.lastname: Sirinian
authors.forename: Georgios
authors.initials: G
authors.lastname: Yiannopoulos
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Andonopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage* / Q000009:adverse effects; D001706:Biopsy; D004334:Drug Administration Schedule; D005260:Female; D005355:Fibrosis; D006115:Greece; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D016014:Linear Models; D008168:Lung / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D058628:Myofibroblasts / Q000187:drug effects / Q000473:pathology; D011237:Predictive Value of Tests; D012129:Respiratory Function Tests; D000069283:Rituximab; D045743:Scleroderma, Diffuse / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab