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Outcomes of patients with systemic sclerosis-associated polyarthritis and myopathy treated with tocilizumab or abatacept: a EUSTAR observational study
  1. Muriel Elhai1,
  2. Marine Meunier1,
  3. Marco Matucci-Cerinic2,
  4. Britta Maurer3,
  5. Gabriela Riemekasten4,
  6. Tifenn Leturcq1,
  7. Raffaele Pellerito5,
  8. Carlos Alberto Von Mühlen6,
  9. Alessandra Vacca7,
  10. Paolo Airo8,
  11. Francesca Bartoli2,
  12. Ginevra Fiori2,
  13. Maria Bokarewa9,
  14. Valeria Riccieri10,
  15. Mike Becker4,
  16. Jérôme Avouac1,
  17. Ulf Müller-Ladner11,
  18. Oliver Distler3,
  19. Yannick Allanore1,
  20. on behalf of EUSTAR (EULAR Scleroderma Trials and Research group)
  1. 1Rheumatology A Department, Paris Descartes University, Cochin Hospital, Paris, France
  2. 2Department of Biomedicine, Section of Rheumatology, Florence, Italy
  3. 3Department of Rheumatology, University Hospital of Zurich, Zurich, Switzerland
  4. 4Department of Rheumatology and Clinical Immunology, German Rheumatology Research Centre, A Leibniz Institute, Charity University Hospital, Berlin, Germany
  5. 5Division of Rheumatology, “Ordine Mauriziano” Hospital, Torino, Italy
  6. 6Rheuma Clinic of Rheumatic Diseases, Porto Alegre, Brazil
  7. 7Chair and Unit of Rheumatology, University Clinic A.O.U. of Cagliari, Monserrato, Italy
  8. 8Rheumatology and Clinical Immunology Unit, Spedali Civili and University of Brescia, Brescia, Italy
  9. 9Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Hospital, University of Gothenburg, Gothenburg, Sweden
  10. 10Rheumatological Unit, Department of Internal Medicine and Clinical Specialities, University of Rome ‘Sapienza’, Rome, Italy
  11. 11Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Kerckhoff Clinic Benekestrasse 2, Bad Nauheim, Germany
  1. Correspondence to Professor Yannick Allanore, Service Rhumatologie A, hôpital Cochin, 27 rue du faubourg St Jacques, Paris 75014, France; yannick.allanore{at}


Objective To evaluate the safety and effectiveness of tocilizumab and abatacept in systemic sclerosis (SSc)-polyarthritis or SSc-myopathy.

Methods 20 patients with SSc with refractory polyarthritis and seven with refractory myopathy from the EUSTAR (EULAR Scleroderma Trials and Research) network were included: 15 patients received tocilizumab and 12 patients abatacept. All patients with SSc-myopathy received abatacept. Clinical and biological assessments were made at the start of treatment and at the last infusion.

Results After 5 months, tocilizumab induced a significant improvement in the 28-joint count Disease Activity Score and its components, with 10/15 patients achieving a EULAR good response. Treatment was stopped in two patients because of inefficacy. After 11 months’ treatment of patients with abatacept, joint parameters improved significantly, with 6/11 patients fulfilling EULAR good-response criteria. Abatacept did not improve muscle outcome measures in SSc-myopathy. No significant change was seen for skin or lung fibrosis in the different groups. Both treatments were well tolerated.

Conclusions In this observational study, tocilizumab and abatacept appeared to be safe and effective on joints, in patients with refractory SSc. No trend for any change of fibrotic lesions was seen but this may relate to the exposure time and inclusion criteria. Larger studies with longer follow-up are warranted to further determine the safety and effectiveness of these drugs in SSc.

  • Systemic Sclerosis
  • Treatment
  • Arthritis

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