To compare clinical parameters in systemic sclerosis(SSc) patients(pts) depending on the decrease of a-Topo-1 during rituximab(RTX) therapy.
This study included 63pts with SSc. The mean follow-up period-26,3±10,7months. The mean age-47years, female-53pts(84%), diffuse cutaneous subset of the disease had 39pts(62%). Interstitial lung disease(ILD) were observed in 60pts(95%). The mean disease duration was 6,03±4,9years. The cumulative mean dose of RTX=2,9±1,1grams. All pts received prednisone at a dose=11,1±4,4mg, immunosuppressants received 43%. All pts were positive for a-Topo-1. Pts were divided into two groups depending on the changes of a-Topo-1 on RTX therapy:group 1 (n=32)–pts with decrease in a-Topo-1 and group 2 (n=31)–pts with stable a-Topo-1. The results are presented in the form of mean values and changes in parameters(Δ).
Considering the entire cohort, an improvement of almost all outcome parameters was found. In group 1 there was ΔActivity score(EScSG-AI)=1,93;ΔRodnan skin score(mRSS)=5,33;Δforced vital capacity %predicted(FVC)=11,9;Δdiffusion capacity for carbon monoxide %predicted(DLCO)=3,2. In group 2: ΔEScSG-AI=1,84;ΔmRSS=4,68;ΔFVC=5,75;ΔDLCO=2,73. When groups were analyzed separately, we observed a significantly higher increase of FVC(p=0,03) and DLCO(p=0,02) in group 1. The a-Тopo-1 level decreased from 174,2±50,1 to 148,1±66,1units/ml(p=0,0009). There was a moderate negative statistically significant correlation between the a-Topo-1 and the total dose of RTX(r=-0,298;p=0,017). A moderate negative statistically significant correlation was found between the a-Topo-1 and FVC(r=-0,322;p=0,009).
In our study there was a greater increase in FVC and DLCO in the group of pts with a decrease of a-Topo-1. Decrease of a-Topo-1 could be considered as a predictor of a better response to RTX therapy in pts with SSc-ILD.