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Correspondence four patients died due to progression of ILD. The frequency of adverse events was low, occurring in only one patient (11%) who developed repeat infections including an osteomyelitis complicating a digital ulcer requiring hospitalisation. Although it is difficult to draw any firm conclusions from these data, according with our experience in this small cohort, TCZ appears to be safe. Its effectiveness as a rescue treatment in patients with refractory SSc-ILD seems modest but not negligible, achieving an improvement or stabilisation of pulmonary function 5 in 44% of patients.