eprintid: 10203111
rev_number: 10
eprint_status: archive
userid: 699
dir: disk0/10/20/31/11
datestamp: 2025-01-10 11:12:10
lastmod: 2025-01-10 11:12:10
status_changed: 2025-01-10 11:12:10
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Goldman, Nina R
creators_name: Nihtyanova, Svetlana I
creators_name: Beesley, Claire F
creators_name: Wells, Athol U
creators_name: Denton, Christopher P
creators_name: Renzoni, Elisabetta A
creators_name: Mageed, Rizgar
creators_name: Ong, Voon H
title: Tocilizumab and rituximab for systemic sclerosis interstitial lung disease: a real-world cohort analysis
ispublished: inpress
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G90
keywords: Anti-topoisomerase antibody, Interstitial lung disease, Rituximab, Systemic Sclerosis, Tocilizumab
note: © The Author(s) 2025. Published by Oxford University Press on behalf of the British Society for Rheumatology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).
abstract: OBJECTIVES: Systemic sclerosis (SSc)-interstitial lung disease (ILD) is one of the leading causes of mortality in SSc. Data from randomised controlled trials (RCTs) supports rituximab and tocilizumab monotherapy but there is limited data regarding their use for those who fail standard immunomodulatory therapies. METHODS: SSc patients treated with rituximab or tocilizumab were retrospectively identified in a single centre cohort. Linear mixed effect models were used to analyse before and after treatment lung function trajectory and identify patient characteristics associated with treatment response. RESULTS: 127 patients were included for analysis. 51 of 94 (51.4%) and 13 of 33 (39.4%) of the rituximab and tocilizumab cohorts respectively were receiving concurrent mycophenolate mofetil. Pre-treatment decline in absolute change %FVC/year and %DLCO/year respectively, was similar in both cohorts (-3.2% and -4.0% rituximab and -3.2% and -3.6% tocilizumab). Both treatments resulted in lung function stabilisation (%FVC/year and %DLCO/year: 1.2% and +0.2% rituximab cohort, 1.0% and 1.0% tocilizumab cohort). Anti-topoisomerase antibody (ATA) positive patients had a significant response on %FVC/year to tocilizumab compared with ATA negative patients. Gender had a significant impact on %FVC/year response to rituximab, with males responding to a greater degree than females. Age, ILD extent and skin subset had no impact on treatment response. CONCLUSION: Combination rituximab or tocilizumab with background immunosuppressive therapy is associated with stabilisation in lung function trajectory among those who remain refractory to standard immunosuppressives. Specific patient characteristics have an impact on lung function response. Improved FVC response among ATA patients receiving tocilizumab validate data from RCTs.
date: 2025-01-03
date_type: published
publisher: Oxford University Press (OUP)
official_url: https://doi.org/10.1093/rheumatology/keaf006
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 2346605
doi: 10.1093/rheumatology/keaf006
medium: Print-Electronic
pii: 7942510
lyricists_name: Denton, Christopher
lyricists_name: Ong, Voon
lyricists_name: Beesley, Claire
lyricists_id: CPDEN87
lyricists_id: VONGX45
lyricists_id: CFBEE41
actors_name: Denton, Christopher
actors_id: CPDEN87
actors_role: owner
full_text_status: public
publication: Rheumatology
event_location: England
citation:        Goldman, Nina R;    Nihtyanova, Svetlana I;    Beesley, Claire F;    Wells, Athol U;    Denton, Christopher P;    Renzoni, Elisabetta A;    Mageed, Rizgar;           Goldman, Nina R;  Nihtyanova, Svetlana I;  Beesley, Claire F;  Wells, Athol U;  Denton, Christopher P;  Renzoni, Elisabetta A;  Mageed, Rizgar;  Ong, Voon H;   - view fewer <#>    (2025)    Tocilizumab and rituximab for systemic sclerosis interstitial lung disease: a real-world cohort analysis.                   Rheumatology        10.1093/rheumatology/keaf006 <https://doi.org/10.1093/rheumatology%2Fkeaf006>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10203111/1/Denton_Tocilizumab%20and%20rituximab%20for%20systemic%20sclerosis%20interstitial%20lung%20disease_AAM2.pdf