The evaluation of rituximab treatment in systemic sclerosis patients

Systemic sclerosis (SSc) is a systemic disease of unknown cause characterized by fibrosis of the skin and internal organs. An exact treatment for this complex and heterogeneous disease in whose pathogenesis autoimmunity, fibrosis and vascular change proceed together has not been found yet. Especially skin, lungs and gastrointestinal system involvement are the areas in which fibrosis mostly occurs. Treatments applied to date aim to prevent fibrosis and vascular pathologies mostly. There is a need for detailed studies on Rituximab, recently used in SSc treatment, about how useful it is clinically. The study was carried out by a retrospective file analysis of SSc patients who were being treated at Division of Rheumatology, Department of Internal Medicine, Gaziantep University. For this purpose, 43 patients with interstitial lung disease (L+) and receiving rituximab, and 38 patients without lung involvement (L-) were involved in the study. The data about complete blood count and biochemical tests, modified Rodnan skin score, forced vital capacity, carbon monoxide diffusion capacity, pulmonary artery pressure and the 6-minute walk test of patients were evaluated retrospectively. Gender distribution of the patients in the L+ SSc group was 34 females and 4males, while it was 35 females and 3 males in the L- SSc group. The average age of patients in the L+ SSc group was 53.3±12.2 years while it was 59.6±10.0 years in the L- SSc group. There was no statistically significant difference in age and gender of the patients (p>0.05). It was found that there was a decrease in the modified Rodnan score and statistically significant increase in the 6-minute walk test. However, the median DLCO in the carbon monoxide diffusion test decreased 58 from 60 contrary to expectations. Rituximab treatment has had an improvement in skin score of patients whereas there are differences in pulmonary findings. Double-blind, randomized controlled trials may show the real efficacy of the medicine by removing bias.