DESIRES trial shows the long-term benefits of using rituximab in patients with systemic sclerosis

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Though rituximab is proven to be a promising therapeutic option for systemic sclerosis (SSc), its long-term outcomes are not evaluated. According to a recent study published in JAMA Dermatology, rituximab treatment has provided significant improvement in skin and lung fibrosis in patients with SSc.

Kuzumi and colleagues conducted a single-center cohort study for analyzing the effects of rituximab treatment in 29 patients with SSc after the DESIRES trial. The follow-up reported significant improvement in modified Rodnan skin score and predicted forced vital capacity after 1 and 3 courses of rituximab treatment. A significant correlation was found between modified Rodnan skin score and serum IgA levels (P<0.01). There was a higher improvement in FVC% predicted in seven patients with low IgM, one patient with low IgA, and one patient with low IgG at the last follow-up. The reduced serum immunoglobins levels were linked to the increased clinical response.

A 2021 study has also reported the positive effects of rituximab on improving skin changes and pulmonary function in SSc patients. This systematic review assessed 10 clinical trials and five studies showed significant improvement in forced vital capacity during follow-up. According to a modified Rodnan skin score, eight studies have reported improvements in skin changes. Experts highlighted the beneficial effects of using rituximab for SSc-related lung disease and cutaneous fibrosis.

Therefore, it is evident that rituximab treatment significantly improves skin and lung fibrosis in SSc patients. Moreover, further randomized, double-blind, multicentre trials are recommended with definite sample numbers and follow-up for an effective conclusion.

References

  1. Kuzumi A, Ebata S, Fukasawa T, Matsuda KM, Kotani H, Yoshizaki-Ogawa A, Sato S, Yoshizaki A. Long-term Outcomes After Rituximab Treatment for Patients With Systemic Sclerosis: Follow-up of the DESIRES Trial With a Focus on Serum Immunoglobulin Levels. JAMA Dermatology. 2023 Feb 15.
  2. Caldas MM, Azevedo KP, Nunes AC, Oliveira VH, Pimenta ID, Araújo ID, Bezerra Neto FA, Oliveira AK, Piuvezam G. Is rituximab effective for systemic sclerosis? A systematic review and meta-analysis. Advances in Rheumatology. 2021 Mar 12;61.