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Experience with rituximab in scleroderma: results from a 1-year, proof-of-principle study.

Daoussis D, Liossis SN, Tsamandas AC, Kalogeropoulou C, Kazantzi A, Sirinian C, Karampetsou M, Yiannopoulos G, Andonopoulos AP - Rheumatology (Oxford) (2009)

Bottom Line: There was a significant increase of forced vital capacity (FVC) in the RTX group compared with baseline (mean +/- s.d.: 68.13 +/- 19.69 vs 75.63 +/- 19.73, at baseline vs 1-year, respectively, P = 0.0018).Similarly, diffusing capacity of carbon monoxide (DL(CO)) increased significantly in the RTX group compared with baseline (mean +/- s.d.: 52.25 +/- 20.71 vs 62 +/- 23.21, at baseline vs 1-year respectively, P = 0.017).To confirm our encouraging results we propose that larger scale, multicentre studies with longer evaluation periods are needed.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Internal Medicine, Patras University Hospital, 26504 Rion, Patras, Greece. jimdaoussis@hotmail.com

ABSTRACT

Objective: To assess the efficacy of rituximab (RTX) in SSc.

Methods: Fourteen patients with SSc were evaluated. Eight patients were randomized to receive two cycles of RTX at baseline and 24 weeks [each cycle consisted of four weekly RTX infusions (375 mg/m(2))] in addition to standard treatment, whereas six patients (control group) received standard treatment alone. Lung involvement was assessed by pulmonary function tests (PFTs) and chest high-resolution CT (HRCT). Skin involvement was assessed both clinically and histologically.

Results: There was a significant increase of forced vital capacity (FVC) in the RTX group compared with baseline (mean +/- s.d.: 68.13 +/- 19.69 vs 75.63 +/- 19.73, at baseline vs 1-year, respectively, P = 0.0018). The median percentage of improvement of FVC in the RTX group was 10.25%, whereas that of deterioration in the controls was 5.04% (P = 0.002). Similarly, diffusing capacity of carbon monoxide (DL(CO)) increased significantly in the RTX group compared with baseline (mean +/- s.d.: 52.25 +/- 20.71 vs 62 +/- 23.21, at baseline vs 1-year respectively, P = 0.017). The median percentage of improvement of DL(CO) in the RTX group was 19.46%, whereas that of deterioration in the control group was 7.5% (P = 0.023). Skin thickening, assessed with the Modified Rodnan Skin Score (MRSS), improved significantly in the RTX group compared with the baseline score (mean +/- s.d.: 13.5 +/- 6.84 vs 8.37 +/- 6.45 at baseline vs 1-year, respectively, P < 0.001).

Conclusion: Our results indicate that RTX may improve lung function in patients with SSc. To confirm our encouraging results we propose that larger scale, multicentre studies with longer evaluation periods are needed.

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Related in: MedlinePlus

Effects of RTX treatment on PFTs. B-cell depletion treatment mediates a significant improvement of FVC (P = 0.002) and DLCO (P = 0.023) at 1 year (A and C, respectively) compared with the values of the control group (B and D). FVC and DLCO values are presented as percentages of predicted values.
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Figure 1: Effects of RTX treatment on PFTs. B-cell depletion treatment mediates a significant improvement of FVC (P = 0.002) and DLCO (P = 0.023) at 1 year (A and C, respectively) compared with the values of the control group (B and D). FVC and DLCO values are presented as percentages of predicted values.

Mentions: At the 1-year evaluation, there was a significant increase of FVC in the RTX group compared with baseline (mean ± s.d.: 68.13 ± 19.69 vs 75.63 ± 19.73, at baseline vs 1 year, respectively, P = 0.0018), whereas no change was noticed in the control group (mean ± s.d.: 86 ± 19.57 vs 81.67 ± 20.69, at baseline vs 1 year, respectively, P = 0.23), as shown in Fig. 1A and B. The median (upper and lower quartile values) percentage of improvement of FVC in the RTX group was 10.25% (6.19–18.65), whereas in the control group FVC deteriorated [median percentage of deterioration (upper and lower quartile values) 5.04% (4.11–11.6)]. Direct comparison of FVC changes recorded at 1 year revealed that the RTX-treated group improved significantly (P = 0.002) compared with the standard treatment (control) group.


Experience with rituximab in scleroderma: results from a 1-year, proof-of-principle study.

Daoussis D, Liossis SN, Tsamandas AC, Kalogeropoulou C, Kazantzi A, Sirinian C, Karampetsou M, Yiannopoulos G, Andonopoulos AP - Rheumatology (Oxford) (2009)

Effects of RTX treatment on PFTs. B-cell depletion treatment mediates a significant improvement of FVC (P = 0.002) and DLCO (P = 0.023) at 1 year (A and C, respectively) compared with the values of the control group (B and D). FVC and DLCO values are presented as percentages of predicted values.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2806066&req=5

Figure 1: Effects of RTX treatment on PFTs. B-cell depletion treatment mediates a significant improvement of FVC (P = 0.002) and DLCO (P = 0.023) at 1 year (A and C, respectively) compared with the values of the control group (B and D). FVC and DLCO values are presented as percentages of predicted values.
Mentions: At the 1-year evaluation, there was a significant increase of FVC in the RTX group compared with baseline (mean ± s.d.: 68.13 ± 19.69 vs 75.63 ± 19.73, at baseline vs 1 year, respectively, P = 0.0018), whereas no change was noticed in the control group (mean ± s.d.: 86 ± 19.57 vs 81.67 ± 20.69, at baseline vs 1 year, respectively, P = 0.23), as shown in Fig. 1A and B. The median (upper and lower quartile values) percentage of improvement of FVC in the RTX group was 10.25% (6.19–18.65), whereas in the control group FVC deteriorated [median percentage of deterioration (upper and lower quartile values) 5.04% (4.11–11.6)]. Direct comparison of FVC changes recorded at 1 year revealed that the RTX-treated group improved significantly (P = 0.002) compared with the standard treatment (control) group.

Bottom Line: There was a significant increase of forced vital capacity (FVC) in the RTX group compared with baseline (mean +/- s.d.: 68.13 +/- 19.69 vs 75.63 +/- 19.73, at baseline vs 1-year, respectively, P = 0.0018).Similarly, diffusing capacity of carbon monoxide (DL(CO)) increased significantly in the RTX group compared with baseline (mean +/- s.d.: 52.25 +/- 20.71 vs 62 +/- 23.21, at baseline vs 1-year respectively, P = 0.017).To confirm our encouraging results we propose that larger scale, multicentre studies with longer evaluation periods are needed.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Internal Medicine, Patras University Hospital, 26504 Rion, Patras, Greece. jimdaoussis@hotmail.com

ABSTRACT

Objective: To assess the efficacy of rituximab (RTX) in SSc.

Methods: Fourteen patients with SSc were evaluated. Eight patients were randomized to receive two cycles of RTX at baseline and 24 weeks [each cycle consisted of four weekly RTX infusions (375 mg/m(2))] in addition to standard treatment, whereas six patients (control group) received standard treatment alone. Lung involvement was assessed by pulmonary function tests (PFTs) and chest high-resolution CT (HRCT). Skin involvement was assessed both clinically and histologically.

Results: There was a significant increase of forced vital capacity (FVC) in the RTX group compared with baseline (mean +/- s.d.: 68.13 +/- 19.69 vs 75.63 +/- 19.73, at baseline vs 1-year, respectively, P = 0.0018). The median percentage of improvement of FVC in the RTX group was 10.25%, whereas that of deterioration in the controls was 5.04% (P = 0.002). Similarly, diffusing capacity of carbon monoxide (DL(CO)) increased significantly in the RTX group compared with baseline (mean +/- s.d.: 52.25 +/- 20.71 vs 62 +/- 23.21, at baseline vs 1-year respectively, P = 0.017). The median percentage of improvement of DL(CO) in the RTX group was 19.46%, whereas that of deterioration in the control group was 7.5% (P = 0.023). Skin thickening, assessed with the Modified Rodnan Skin Score (MRSS), improved significantly in the RTX group compared with the baseline score (mean +/- s.d.: 13.5 +/- 6.84 vs 8.37 +/- 6.45 at baseline vs 1-year, respectively, P < 0.001).

Conclusion: Our results indicate that RTX may improve lung function in patients with SSc. To confirm our encouraging results we propose that larger scale, multicentre studies with longer evaluation periods are needed.

Show MeSH
Related in: MedlinePlus