1. Potential efficacy of T and B lymphocyte-targeted therapies on articular involvement of patients with rheumatoid arthritis and systemic sclerosis overlap syndrome. Results from a 2-centre series of 19 cases.
- Author
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Lebel N, Marie I, Grosjean J, Brevet P, Leclercq M, Dumont A, Levesque H, Benhamou Y, Marcelli C, Lequerre T, and Vittecoq O
- Subjects
- Humans, Middle Aged, Female, Male, Retrospective Studies, Treatment Outcome, Aged, Adult, Rituximab therapeutic use, T-Lymphocytes immunology, T-Lymphocytes drug effects, Molecular Targeted Therapy, Tumor Necrosis Factor Inhibitors therapeutic use, Severity of Illness Index, Glucocorticoids therapeutic use, Time Factors, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid immunology, Arthritis, Rheumatoid diagnosis, Antirheumatic Agents therapeutic use, Scleroderma, Systemic drug therapy, Scleroderma, Systemic immunology, Scleroderma, Systemic complications, B-Lymphocytes drug effects, B-Lymphocytes immunology, Antibodies, Monoclonal, Humanized therapeutic use, Abatacept therapeutic use
- Abstract
Objectives: To analyse in routine practice the efficacy of targeted therapies on joint involvement of patients with rheumatoid arthritis/systemic sclerosis (RA/SSc) overlap syndrome., Methods: This was a retrospective analysis of medical records of two academic centres over a 10-year period. Joint response to targeted therapies was measured according to EULAR criteria based on Disease Activity Score (DAS)-28. In addition, changes in CRP level and glucocorticoid consumption were recorded., Results: Nineteen patients were included. Methotrexate (n=11) and hydroxychloroquine (n=4) were the most used first-line treatments. Targeted therapies were frequently used (n=14). Tocilizumab was the most selected therapy (n=8), then rituximab (n=5), abatacept and anti-tumour necrosis factor (n=4). Twenty-one treatment sequences were assessed, including 18 with EULAR response criteria. Responses were "good" or "moderate" in 100% (4/4) of patients treated with abatacept, 80% (4/5) with rituximab, 40% (2/5) with tocilizumab, and 25% (1/4) with anti-TNF. T and B lymphocyte-targeted therapies (abatacept, rituximab) resulted more frequently in a "good" or "moderate" response compared to cytokine inhibitors (tocilizumab, etanercept, infliximab) with a significant decrease in DAS-28 at 6 months (-1.75; p=0.016) and a trend to a lower consumption of glucocorticoids., Conclusions: In patients with RA/SSc overlap syndrome refractory to conventional synthetic-DMARDs, T and B lymphocyte-targeted therapies seem to be a promising therapeutic option to control joint activity.
- Published
- 2024
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