Rituximab for the therapy of systemic sclerosis: a series of 10 cases in a single center.
Systemic sclerosis (SSc) is a chronic autoimmune disease with a high morbidity and mortality. Although cyclophosphamide is effective for severe and refractory cases, there is demand for new treatments. The biological treatment with B-cell depletion with rituximab (RTX) has demonstrated efficacy for this demand in open-label studies.


OBJECTIVE
This study was conducted with the aim to retrospectively evaluate all patients who used RTX for the treatment of SSc in our center.


METHODS
We retrospectively evaluated medical records of all patients with SSc who used RTX to treat this disease from January 2009 to January 2015. Systemic, cutaneous, and pulmonary involvement data and laboratory results before and six months after the first infusion of RTX were collected.


RESULTS
Ten patients received treatment during the study period and were included in this series. All patients had a diffuse form of the disease. Five patients suffered from an early (duration of disease shorter or equal to four years), rapidly progressive disease, and another five received RTX at late stages of the disease. In both groups of patients, stabilization of the pulmonary picture was observed, with a fall in the skin score in those patients with early forms of the disease.


CONCLUSIONS
Similar to findings in previous studies, RTX was effective in treating early and rapidly progressive forms of SSc. We also found that patients with long-term illness may benefit from the treatment.
Disciplina de Reumatologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil. Electronic address: veronicavilelavs@yahoo.com.br.
Verônica Silva
VS
Vilela
Disciplina de Reumatologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.
Giselle Baptista
GB
Maretti
Disciplina de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), RIo de Janeiro, RJ, Brazil.
Lívia Marques da Silva
LM
Gama
Disciplina de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), RIo de Janeiro, RJ, Brazil.
Claudia Henrique da
CH
Costa
Disciplina de Pneumologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), RIo de Janeiro, RJ, Brazil.
Rogério Lopes
RL
Rufino
Disciplina de Reumatologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.
Roger A
RA
Levy
D001402:B-Lymphocytes; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008168:Lung; D012189:Retrospective Studies; D000069283:Rituximab / Q000627:therapeutic use*; D012595:Scleroderma, Systemic / Q000188:drug therapy*; D016896:Treatment Outcome
D007155:Immunologic Factors; D000069283:Rituximab
Esclerose sistêmica; Escore cutâneo modificado de Rodnan; Fibrose pulmonar; Modified Rodnan skin score; Pulmonary fibrosis; Rituximab; Rituximabe; Systemic sclerosis