Rituximab therapy is more effective than cyclophosphamide therapy for Japanese patients with anti-topoisomerase I-positive systemic sclerosis-associated interstitial lung disease.
Adult
Cyclophosphamide
/ therapeutic use
DNA Topoisomerases, Type I
/ immunology
Female
Humans
Immunosuppressive Agents
/ therapeutic use
Japan
Lung Diseases, Interstitial
/ drug therapy
Male
Middle Aged
Retrospective Studies
Rituximab
/ therapeutic use
Scleroderma, Systemic
/ complications
Young Adult
cyclophospamide
rituximab
skin sclerosis
systemic sclerosis
systemic sclerosis-associated interstitial lung disease
Journal
The Journal of dermatology
ISSN: 1346-8138
Titre abrégé: J Dermatol
Pays: England
ID NLM: 7600545
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
02
06
2019
accepted:
15
08
2019
pubmed:
11
9
2019
medline:
14
4
2020
entrez:
11
9
2019
Statut:
ppublish
Résumé
Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is the most frequent cause of death for SSc but there is still no sufficient treatment available. Although cyclophosphamide (CYC) therapy is a common treatment which has shown statistical efficacy against SSc-ILD to date, its effects are temporary and not enough. Rituximab (RTX), the anti-CD20 monoclonal antibody, has recently shown efficacy in many autoimmune diseases. In SSc-ILD, RTX is also considered to be one of the novel treatment candidates. However, studies of SSc-ILD in Japanese treated with RTX have only a few case reports. Therefore, in this study, we retrospectively compared nine patients treated with RTX and 30 patients treated with CYC to investigate the efficacy of RTX treatment for Japanese anti-topoisomerase I-positive SSc-ILD patients. At the 24-month evaluation, the improvement rates of percent predicted of forced vital capacity and percent predicted of diffusing capacity of the lung carbon monoxide in the RTX-treated group were significantly higher than those in the CYC-treated group (20.6 ± 8.8% vs 1.1 ± 3.9%; P < 0.05 and 34.0 ± 6.0% vs -1.5 ± 2.8%; P < 0.01, respectively). In addition, skin thickness scores also showed a marked improvement from 13.5 points before the start of treatment to 5.8 points after 24 months by RTX therapy (P < 0.05). These results suggest that RTX treatment is more effective for Japanese SSc-ILD patients than CYC treatment. In the future, it is expected that large-scale clinical trials will show the usefulness of RTX treatment for SSc-ILD.
Identifiants
pubmed: 31502326
doi: 10.1111/1346-8138.15079
doi:
Substances chimiques
Immunosuppressive Agents
0
Rituximab
4F4X42SYQ6
Cyclophosphamide
8N3DW7272P
DNA Topoisomerases, Type I
EC 5.99.1.2
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1006-1013Informations de copyright
© 2019 Japanese Dermatological Association.
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