Your browser doesn't support javascript.
Open questions on the management of targeted therapies for the treatment of systemic sclerosis-interstitial lung disease: results of a EUSTAR survey based on a systemic literature review.
Campochiaro, Corrado; Lazzaroni, Maria Grazia; Bruni, Cosimo; Zanatta, Elisabetta; De Luca, Giacomo; Matucci-Cerinic, Marco.
  • Campochiaro C; Unit of Immunology, Rheumatology, Allergy and Rare Disease, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy. Via Olgettina 60, 20132, Milan, Italy.
  • Lazzaroni MG; Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.
  • Bruni C; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
  • Zanatta E; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
  • De Luca G; Department of Geriatric Medicine, Division of Rheumatology AOUC, Florence, Italy.
  • Matucci-Cerinic M; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Ther Adv Musculoskelet Dis ; 14: 1759720X221116408, 2022.
Article in English | MEDLINE | ID: covidwho-2009255
ABSTRACT

Background:

The results of randomized controlled (RCT) and retrospective studies have expanded the armamentarium of drugs for systemic sclerosis (SSc) - interstitial lung disease (ILD) treatment. The correct positioning of these drugs is not yet clarified.

Objectives:

Systemic literature review (SLR) on rituximab (RTX), tocilizumab (TCZ), nintedanib and abatacept (ABT) for the treatment of SSc-ILD. The results of the SLR were used to create a dedicated survey.

Design:

The study was performed as a systematic review. Data sources and

methods:

the SLR was performed using the following terms "(systemic sclerosis OR scleroderma) AND (interstitial lung disease OR lung fibrosis OR pulmonary fibrosis) AND (rituximab OR tocilizumab OR abatacept OR nintedanib)". The results of the SLR were integrated in a survey including 8 domains. These were sent to all EUSTAR members and to the participants of the 2020 Scleroderma World Congress.

Results:

41 studies (34 on RTX, 5 on TCZ, 2 on ABT, and 1 on nintedanib) were identified. RCTs supported the use of TCZ and nintedanib, while retrospective studies supported the use of RTX for SSc-ILD. No clear data were obtained about ABT. The survey showed that RTX is the most available option (96%) whereas the most frequent reason for targeted therapy introduction is lung progression while on csDMARDs (86% RTX, 59% TCZ and 63% nintedanib). Combination therapy was the most frequently mentioned therapeutic scheme for nintedanib (75%) and RTX (63%). Physicians' perception of safety was similar for all drugs, while drug efficacy was the same for RTX and nintedanib, followed by TCZ (4.8 ± 2). The most frequently raised concerns pertained to efficacy, safety and combination regimens.

Conclusion:

Our SLR supports the use of RTX, TCZ and nintedanib for SSc-ILD patients and underlines the need for more data about upfront combination versus monotherapy. It also highlighted the need to identify predictors supporting drug choice according to both pulmonary and extra-pulmonary manifestations.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: Ther Adv Musculoskelet Dis Year: 2022 Document Type: Article Affiliation country: 1759720X221116408

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: Ther Adv Musculoskelet Dis Year: 2022 Document Type: Article Affiliation country: 1759720X221116408