title: Outcomes of patients with systemic sclerosis-associated polyarthritis and myopathy treated with tocilizumab or abatacept: a EUSTAR observational study.
abstract: OBJECTIVE
  To evaluate the safety and effectiveness of tocilizumab and abatacept in systemic sclerosis (SSc)-polyarthritis or SSc-myopathy.
  
  
  METHODS
  20 patients with SSc with refractory polyarthritis and seven with refractory myopathy from the EUSTAR (EULAR Scleroderma Trials and Research) network were included: 15 patients received tocilizumab and 12 patients abatacept. All patients with SSc-myopathy received abatacept. Clinical and biological assessments were made at the start of treatment and at the last infusion.
  
  
  RESULTS
  After 5 months, tocilizumab induced a significant improvement in the 28-joint count Disease Activity Score and its components, with 10/15 patients achieving a EULAR good response. Treatment was stopped in two patients because of inefficacy. After 11 months' treatment of patients with abatacept, joint parameters improved significantly, with 6/11 patients fulfilling EULAR good-response criteria. Abatacept did not improve muscle outcome measures in SSc-myopathy. No significant change was seen for skin or lung fibrosis in the different groups. Both treatments were well tolerated.
  
  
  CONCLUSIONS
  In this observational study, tocilizumab and abatacept appeared to be safe and effective on joints, in patients with refractory SSc. No trend for any change of fibrotic lesions was seen but this may relate to the exposure time and inclusion criteria. Larger studies with longer follow-up are warranted to further determine the safety and effectiveness of these drugs in SSc.
authors.affiliation: Rheumatology A Department, Paris Descartes University, Cochin Hospital, Paris, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Elhai
authors.forename: Marine
authors.initials: M
authors.lastname: Meunier
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.forename: Britta
authors.initials: B
authors.lastname: Maurer
authors.forename: Gabriela
authors.initials: G
authors.lastname: Riemekasten
authors.forename: Tifenn
authors.initials: T
authors.lastname: Leturcq
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pellerito
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Von Mühlen
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vacca
authors.forename: Paolo
authors.initials: P
authors.lastname: Airo
authors.forename: Francesca
authors.initials: F
authors.lastname: Bartoli
authors.forename: Ginevra
authors.initials: G
authors.lastname: Fiori
authors.forename: Maria
authors.initials: M
authors.lastname: Bokarewa
authors.forename: Valeria
authors.initials: V
authors.lastname: Riccieri
authors.forename: Mike
authors.initials: M
authors.lastname: Becker
authors.forename: Jérôme
authors.initials: J
authors.lastname: Avouac
authors.forename: Ulf
authors.initials: U
authors.lastname: Müller-Ladner
authors.forename: Oliver
authors.initials: O
authors.lastname: Distler
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
mesh_terms: D000069594:Abatacept; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D012595:Scleroderma, Systemic / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D018796:Immunoconjugates; D000069594:Abatacept; C502936:tocilizumab