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Tocilizumab Preserves Lung Function in Early Systemic Sclerosis

Stabilization of lung function independent of the extent of quantitative radiographic interstitial lung disease or fibrosis at baseline

FRIDAY, April 23, 2021 (HealthDay News) — Tocilizumab prevents progression of interstitial lung disease in patients with early systemic sclerosis (SSc), according to a study recently published in Arthritis & Rheumatology.

David Roofeh, M.D., from the University of Michigan Scleroderma Program in Ann Arbor, and colleagues performed a post-hoc analysis of data from a phase 3 trial that assessed the impact of tocilizumab on lung function preservation among patients with SSc and progressive skin disease. Treatment arms were stratified by the degree of radiographic lung involvement as mild (5 to 10 percent), moderate (>10 to 20 percent), or severe (>20 percent) interstitial lung disease. Spirometry was conducted at baseline and throughout the 48 weeks. High-resolution chest computed tomography was conducted at baseline and week 48. The analysis included 210 patients.

The researchers found that 65 percent of patients had interstitial lung disease, and of these patients, 77 percent had moderate-to-severe involvement defined by >10 percent lung involvement. Among those randomly assigned to tocilizumab, there was preservation of forced vital capacity over 48 weeks (least squared mean change in percent-predicted, −0.1) versus placebo (−6.3 percent). The mean declines in the percentage of predicted forced vital capacity in the tocilizumab arm at 48 weeks were −4.1 for mild, 0.7 for moderate, and 2.1 for severe quantitative interstitial lung disease versus −10.0, −5.7, and −6.7, respectively, in the placebo group. Independent of fibrosis severity, similar treatment-related preservation was seen.

“I hope this data suggests a possible paradigm shift in terms of treatment for these patients, providing an option of early detection and secondary-prevention, identifying the disease in the subclinical state, rather than later trying to reduce the impact of clinically significant disease,” a coauthor said in a statement.

Several authors disclosed financial ties to the pharmaceutical, biopharmaceutical, and biotechnology industries.

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