Treatment of systemic sclerosis with tocilizumab

Neves, Marisa; Oliveira, Susana; Amaral, Marta; Alves, José Delgado

doi:10.1093/rheumatology/keu435

Cited by 36 publications

(33 citation statements)

References 7 publications

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“…Internal organ involvement remained stable, namely lung and renal impairment [18]. Other cases were subsequently reported, reinforcing the role of tocilizumab as a valuable treatment option in dcSSc, improving skin thickness, halting lung fibrosis and reducing the patient's Global Disease Activity scores [19,20].…”

Section: B-cell Depletionmentioning

confidence: 75%

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Biological Therapy in Systemic Sclerosis

Caetano¹,

Oliveira²,

Alves³

2017

Systemic Sclerosis

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Systemic sclerosis is the autoimmune connective tissue disease with the highest morbidity and mortality, through the combination of inflammation, vasculopathy and fibrosis leading to severe internal organ involvement. Currently, there are no approved diseasemodifying therapies, and treatment is based on organ-specific treatment and broad immunosuppression, with disappointing long-term results in most cases. Recent research has helped to improve knowledge of the pathogenesis of systemic sclerosis and to optimize treatment based on specific physiopathological targets, and a new era of biological agents in systemic sclerosis has now begun. Promising results are emerging from targeting specific cytokine signalling, especially IL-6, and cellular subpopulations such as B cells, with anti-CD20 therapy, and T-cells, with inhibition of T-cell co-stimulation. Other approaches under evaluation are based on the modulation of profibrotic pathways by anti-TGF-β agents. In this chapter, we discuss the available evidence to support the use of each biological agent in systemic sclerosis based on data from basic and translational research and on results from clinical studies.

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Section: B-cell Depletionmentioning

confidence: 75%

“…After treatment for 6 months, the skin score improved in all three patients, and the patients' global assessment also improved. In two patients, there was a halt in the progression of lung fibrosis, on lung high-resolution CT scan (HRCT) and lung function tests [20].…”

Section: In a European League Against Rheumatism (Eular) Systemic Sclmentioning

confidence: 99%

Biological Therapy in Systemic Sclerosis

Caetano¹,

Oliveira²,

Alves³

2017

Systemic Sclerosis

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“…Following on from the observational study of tocilizumab and abatacept in patients with SScassociated joint disease (mentioned above), a case series published by Fernandes das Neves et al demonstrated evidence of clinical improvement in three treatment-refractory SSc patients treated with tocilizumab [68,77]. More recently, the safety and efficacy of tocilizumab in SSc was studied in a phase II, double-blind, randomised, placebo-controlled trial of 87 patients with a disease duration of less than 5 years [78].…”

Section: Il-6 Inhibitorsmentioning

confidence: 99%

Translating Autoimmune Pathogenesis into Targeted Therapies for Systemic Sclerosis

Russell¹,

Sofat²

2017

Immunopathogenesis and Immune-Based Therapy for Selected Autoimmune Disorders

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Targeted therapies including tumour necrosis factor α (TNFα) inhibitors have transformed the management of a number of autoimmune conditions over the past 20 years. One autoimmune rheumatological condition with significant potential for the development of targeted therapies is systemic sclerosis (SSc). In this chapter, we use SSc as an example of how research into the pathogenic processes underlying autoimmune conditions can be translated into novel targeted therapies. We review the evidence base for a range of targeted therapies for SSc identified from a systematic literature search, before highlighting a number of studies currently underway.

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“…Tocilizumab is a monoclonal anti-IL-6R antibody that is already ap-proved as second line therapy for the treatment of RA [34,[36][37][38]. It has also been tested in other inflammatory diseases [39][40][41]. In a placebo-controlled phase I trial in 36 patients with active CD 80% of the patients treated with tocilizumab showed a clinical response compared with 31% of patients in the placebo group.…”

Section: Antibodies Directed Against Cytokinesmentioning

confidence: 99%

Where are we heading to in pharmacological IBD therapy?

Rogler

2015

Pharmacological Research

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Treatment of systemic sclerosis with tocilizumab

Cited by 36 publications

References 7 publications

Biological Therapy in Systemic Sclerosis

Biological Therapy in Systemic Sclerosis

Translating Autoimmune Pathogenesis into Targeted Therapies for Systemic Sclerosis

Where are we heading to in pharmacological IBD therapy?

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