Tocilizumab and Rituximab in Systemic Sclerosis: A Real-Life Retrospective Observational Study Across Different...

Area of Science:

• Rheumatology and Immunology
• Clinical Pharmacology

Background:

• Systemic sclerosis (SSc) is a complex autoimmune disease with limited treatment options.
• Tocilizumab (TCZ) and rituximab (RTX) are biologic agents explored for SSc management.
• Real-world data on the efficacy and safety of TCZ and RTX in SSc are limited.

Purpose of the Study:

• To evaluate the real-world efficacy and safety of tocilizumab (TCZ) and rituximab (RTX) in systemic sclerosis (SSc) patients.
• To assess the impact of TCZ and RTX on global clinical outcomes and lung function across different SSc phenotypes and treatment lines.
• To explore trends in disease activity and lung function over 12-24 months of treatment.

Main Methods:

• Retrospective cohort study of 50 SSc patients (27 on TCZ, 23 on RTX) followed for 12-24 months.
• Clinical measures including modified Rodnan Skin Score (mRSS), C-reactive protein (CRP), and revised EUSTAR activity index (RAI) were recorded.
• Spirometric parameters (FVC%, DLCO%) were assessed; statistical methods for repeated measures were applied.

Main Results:

• Both TCZ and RTX groups showed significant decreases in mRSS, CRP, and RAI over time.
• RTX was used earlier in disease, while TCZ was often rescue therapy; RTX group had greater absolute mRSS improvement.
• Lung function (FVC%, DLCO%) showed modest decline/stability; low rates of functional progression observed; favorable safety profiles with no AEs leading to discontinuation.

Conclusions:

• Both TCZ and RTX demonstrated positive effects on SSc disease activity and lung function with good safety.
• Real-world data support the use of TCZ and RTX in SSc, though comparative effectiveness is limited by baseline imbalances.
• These findings suggest TCZ and RTX can be valuable in managing SSc in different clinical contexts.