Systemic sclerosis & Raynaud's
Combination therapy of rituximab and mycophenolate in patients with systemic sclerosis and primary cardiac involvement refractory to cyclophosphamide: a retrospective exploratory analysis of 10 cases
Authors' conclusion
Our findings suggest that combination therapy with RTX and MMF may be an effective approach for improving refractory cardiac manifestations in patients with SSc.
Study context
- Population
- Patients with systemic sclerosis (SSc)-related primary cardiac involvement (troponin T elevation plus ≥1 cardiac manifestation) refractory to previous cyclophosphamide (CP)
- Participants
- 10 patients
- Outcome
- Cardiac outcomes
- Follow-up
- 6-12-month follow-up
Methodological detailsretrospective medical records analysis, exploratory, single-centre
- Retrospective medical records analysis
- Exploratory
- Single-centre
Main finding
As reported in the abstract
Cardiac outcomes after initiation of RTX/MMF
- Consistent decreases in plasma troponin T in all patients
- p=0.0020
- Left ventricular ejection fraction (LVEF) improved between 3% and 23% in five of the six patients with reduced LVEF
- 5/6
- Rate of ventricular extrasystoles declined in all assessable patients (n=6)
- p=0.0313
- NT-proBNP decreased in six of the nine patients with elevated levels
- 6/9
Observational data: associations, not effects.
Further findings
Modified Rodnan skin score
- Significant reductions
- P = 0.0020
Safety
Serious adverse events · long-term follow-up of up to 6 years
- Serious adverse events
- 7
- Infections
- 5
- Fatal events
- 2
- Rituximab (RTX)/MMF combination generally well tolerated
Original publication
Combination therapy of rituximab and mycophenolate in patients with systemic sclerosis and primary cardiac involvement refractory to cyclophosphamide: a retrospective exploratory analysis of 10 cases. RMD Open. Published 10 June 2025. doi:10.
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