Systemic sclerosis & Raynaud's
Tocilizumab and rituximab for systemic sclerosis interstitial lung disease: a real-world cohort analysis
Authors' conclusion
Combination rituximab or tocilizumab with background immunosuppressive therapy is associated with stabilization in lung function trajectory among those who remain refractory to standard immunosuppressives.
Study context
- Population
- SSc patients with ILD treated with RTX or tocilizumab, single-centre cohort, incl. those refractory to standard immunosuppressives
- Participants
- 127 patients
- Exposure
- RTX vs tocilizumab in SSc-ILD
- Rituximabn = 94
- Tocilizumabn = 33
- Outcome
- Lung function trajectory before and after treatment (absolute change %FVC/year and %DLCO/year)
Methodological detailssingle-centre, linear mixed effect models, before and after treatment comparison
- Single-centre
- Linear mixed effect models
- Before and after treatment comparison
Main finding
As reported in the abstract
Post-treatment lung function trajectory (%FVC/year and %DLCO/year)
| Group | Value | %DLCO/year |
|---|---|---|
| Rituximab | 1.2% %FVC/year | +0.2% |
| Tocilizumab | 1.0% %FVC/year | 1.0% |
Value
Rituximab1.2% %FVC/year
Tocilizumab1.0% %FVC/year
%DLCO/year
Rituximab+0.2%
Tocilizumab1.0%
Observational data: associations, not effects.
Further findings
Concurrent MMF
| Outcome | Rituximab | Tocilizumab |
|---|---|---|
| Pre-treatment decline in lung function (%FVC/year and %DLCO/year) | −3.2% %FVC/year | −3.2% %FVC/year |
| %DLCO/year | −4.0% | −3.6% |
Pre-treatment decline in lung function (%FVC/year and %DLCO/year)
- Similar in both cohorts
Predictors of treatment response
- Anti-topoisomerase antibody (ATA)-positive patients had a significant %FVC/year response to tocilizumab vs ATA-negative
- Males responded to RTX on %FVC/year to a greater degree than females
- Age, ILD extent and skin subset had no impact on treatment response
Original publication
Tocilizumab and rituximab for systemic sclerosis interstitial lung disease: a real-world cohort analysis. Rheumatology (Oxford). Published 3 January 2025. doi:10.
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