{
  "abstract": "Background Tocilizumab (TCZ) has shown beneficial effects on interstitial lung disease (ILD) in systemic sclerosis (SSc). We aimed to assess the real-life safety and effectiveness of TCZ on several SSc-related domains using data from a French-Italian multicentre cohort.Methods We conducted a retrospective analysis of patients with SSc treated with TCZ across 15 referral centres. The following clinical data were collected at 12 months before TCZ initiation, at baseline and at 12 and 24 months of treatment: modified Rodnan skin score (mRSS), pulmonary function tests, Disease Activity Score in 28 joints using C reactive protein, digital ulcers and cardiac biomarkers. ILD progression was defined as a decline ≥5 in %predicted forced vital capacity (%pFVC) over 12±3 months.Results 197 patients were included (88% female; median age 57 years; median disease duration 9 years); 67% were antitopoisomerase I positive. TCZ monotherapy was used in 29% of cases, methotrexate was the most frequent combined treatment (35%). In SSc-associated ILD, %pFVC declined significantly from −12 months to baseline (81% to 77%; p=0.003). On TCZ introduction, %pFVC stabilised and the proportion of progressors declined from 43% to 24% (p=0.015). Among diffuse cutaneous patients, mRSS decreased significantly at 12 and 24 months. Digital ulcers, arthritis activity and cardiac biomarkers also improved. Infections were the most frequent adverse events (22.8%). TCZ was discontinued in 32% of patients, mainly for inefficacy. Pulmonary arterial hypertension and older age predicted TCZ failure, whereas elevated CRP predicted better response.Conclusions In this large real-life cohort, TCZ was safe and associated with consistent benefits across different domains, supporting its role as a potential disease-modifying treatment in selected patients with SSc.",
  "authors": [
    {
      "affiliations": [
        "IRCCS and INFLAGE San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy",
        "Department of Rheumatology, Université Paris Cité, Cochin Institute, Paris, France"
      ],
      "name": "Giulia Buonsante"
    },
    {
      "affiliations": [
        "Unit of Immunology, Rheumatology, Allergy, and Rare Diseases (UnIRAR), San Raffaele Hospital, Milan, Italy",
        "Vita-Salute San Raffaele University, Milan, Italy"
      ],
      "name": "Giacomo De Luca"
    },
    {
      "affiliations": [
        "SC Reumatologia, Università di Pavia, Pavia, Italy"
      ],
      "name": "Elena Marazzi"
    },
    {
      "affiliations": [
        "Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, Università degli Studi di Bari Aldo Moro, Bari, Italy"
      ],
      "name": "Fabio Cacciapaglia"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy"
      ],
      "name": "Maria Grazia Lazzaroni"
    },
    {
      "affiliations": [
        "Rheumatology, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "Marco De Pinto"
    },
    {
      "affiliations": [
        "Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy",
        "Clinica Medica, AOU Ospedali Riuniti di Ancona, Ancona, Italy"
      ],
      "name": "Devis Benfaremo"
    },
    {
      "affiliations": [
        "Scleroderma Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy"
      ],
      "name": "Valentina Longo"
    },
    {
      "affiliations": [
        "Department of Precision Medicine, University of Campania Luigi Vanvitelli, Caserta, Italy"
      ],
      "name": "Carlo Iandoli"
    },
    {
      "affiliations": [
        "Department of Precision Medicine, University of Campania Luigi Vanvitelli, Caserta, Italy"
      ],
      "name": "Giovanna Cuomo"
    },
    {
      "affiliations": [
        "Unit of Rheumatology, Universita degli Studi di Padova Scuola di Medicina e Chirurgia, Padua, Italy"
      ],
      "name": "Anna Cuberli"
    },
    {
      "affiliations": [
        "DIMED, Universita degli Studi di Padova Dipartimento di Medicina, Padova, Italy"
      ],
      "name": "Elisabetta Zanatta"
    },
    {
      "affiliations": [
        "Internal Medicine, CHU de Rennes, Rennes, France"
      ],
      "name": "Alain Lescoat"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy"
      ],
      "name": "Silvia Bellando-Randone"
    },
    {
      "affiliations": [
        "Gaetano Pini-CTO, Milan, Italy",
        "Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy"
      ],
      "name": "Giorgia Trignani"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy"
      ],
      "name": "Serena Guiducci"
    },
    {
      "affiliations": [
        "Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy",
        "Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy"
      ],
      "name": "Lorenzo Beretta"
    },
    {
      "affiliations": [
        "Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy",
        "Clinica Medica, AOU Ospedali Riuniti di Ancona, Ancona, Italy"
      ],
      "name": "Gianluca Moroncini"
    },
    {
      "affiliations": [
        "University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "Dilia Giuggioli"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy"
      ],
      "name": "Paolo Airò"
    },
    {
      "affiliations": [
        "Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, Università degli Studi di Bari Aldo Moro, Bari, Italy"
      ],
      "name": "Florenzo Iannone"
    },
    {
      "affiliations": [
        "SC Reumatologia, Università di Pavia, Pavia, Italy"
      ],
      "name": "Veronica Codullo"
    },
    {
      "affiliations": [
        "Rheumatology, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Rome, Italy"
      ],
      "name": "Silvia Laura Bosello"
    },
    {
      "affiliations": [
        "Scleroderma Clinic, Gaetano Pini-CTO, Milan, Italy"
      ],
      "name": "Nicoletta Del Papa"
    },
    {
      "affiliations": [
        "Rhumatologie, CHU Bordeaux GH Pellegrin, Bordeaux, France"
      ],
      "name": "Marie-Elise Truchetet"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Université Paris Cité, Cochin Institute, Paris, France"
      ],
      "name": "Jerome Avouac"
    },
    {
      "affiliations": [
        "Unit of Immunology, Rheumatology, Allergy, and Rare Diseases (UnIRAR), San Raffaele Hospital, Milan, Italy",
        "Vita-Salute San Raffaele University, Milan, Italy"
      ],
      "name": "Lorenzo Dagna"
    },
    {
      "affiliations": [
        "IRCCS and INFLAGE San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy",
        "Unit of Immunology, Rheumatology, Allergy, and Rare Diseases (UnIRAR), San Raffaele Hospital, Milan, Italy",
        "Division of Clinical and Experimental Rheumatology l Medicine, Vita-Salute San Raffaele University, Milan, Italy"
      ],
      "name": "Marco Matucci-Cerinic"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Université Paris Cité, Cochin Institute, Paris, France"
      ],
      "name": "Yannick Allanore"
    },
    {
      "affiliations": [
        "IRCCS and INFLAGE San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy",
        "Unit of Immunology, Rheumatology, Allergy, and Rare Diseases (UnIRAR), San Raffaele Hospital, Milan, Italy",
        "Vita-Salute San Raffaele University, Milan, Italy"
      ],
      "name": "Corrado Campochiaro"
    }
  ],
  "title": "Safety and effectiveness of tocilizumab in systemic sclerosis: a multicentre French-Italian study",
  "uid": "3e2120ba-8696-5596-a790-00e268044049"
}