Experience with rituximab in scleroderma: results from a 1-year, proof-of-principle study.
Experience with rituximab in scleroderma: results from a 1-year, proof-of-principle study.
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DOI：
10.1093/rheumatology/kep093
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发表时间：
2010-02
期刊：
影响因子：
--
通讯作者：
Andonopoulos AP
中科院分区：
文献类型：
--
作者：
Daoussis D;Liossis SN;Tsamandas AC;Kalogeropoulou C;Kazantzi A;Sirinian C;Karampetsou M;Yiannopoulos G;Andonopoulos AP
目标。评价利妥昔单抗（RTX）治疗SSc的疗效。方法。对14例SSc患者进行评估。8例患者在基线和24周随机接受2个RTX周期[每个周期包括4周RTX输注（375 mg/m2）]，而6例患者（对照组）单独接受标准治疗。通过肺功能检查（PFTs）和胸部高分辨率CT （HRCT）评估肺受累情况。对皮肤受累情况进行临床和组织学评估。结果。与基线相比，RTX组的强迫肺活量（FVC）显著增加（平均±s.d: 68.13±19.69 vs 75.63±19.73，基线与1年，P = 0.0018）。RTX组FVC改善的中位数百分比为10.25%，而对照组恶化的中位数百分比为5.04% （P = 0.002）。同样，与基线相比，RTX组的一氧化碳弥散能力（DLCO）显著增加（平均±s.d: 52.25±20.71 vs 62±23.21，基线和1年，P = 0.017）。RTX组DLCO改善的中位数百分比为19.46%，而对照组恶化的中位数百分比为7.5% （P = 0.023）。用改良罗德曼皮肤评分（MRSS）评估皮肤增厚，与基线评分相比，RTX组的皮肤增厚显著改善（平均±s.d：基线时的13.5±6.84 vs基线时的8.37±6.45 vs 1年，P < 0.001）。结论。我们的结果表明RTX可以改善SSc患者的肺功能。为了证实我们令人鼓舞的结果，我们建议需要更大规模、更长的评估期的多中心研究。
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/m2)] 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 (DLCO) 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 DLCO 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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作者：
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