ArticleRMD open2025
Combination therapy of rituximab and mycophenolate in patients with systemic sclerosis and primary cardiac involvement refractory to cyclophosphamide: a retrospective exploratory analysis of 10 cases.
Article in RMD open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Article
- Arrhythmias in Systemic Sclerosis: A Call for Interdisciplinarity Teams.Life (Basel, Switzerland) · 2025Review
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite the high mortality risk, no specific treatment options for cardiac manifestations in systemic sclerosis (SSc) currently exist. We performed a retrospective medical records analysis at our centre to explore the therapeutic effects of a combination therapy with rituximab (RTX) and mycophenolate (MMF) in 10 patients with SSc-related primary cardiac involvement refractory to previous primary treatment with cyclophosphamide (CP).SSc-related primary cardiac involvement was defined as the presence of troponin T elevation and of at least one of the following cardiac manifestations: right or left ventricular systolic or diastolic dysfunction, myocarditis, pericarditis, heart blocks or ventricular arrhythmias. Patients who had worsening or persistence of cardiac involvement after CP pulse therapy received a combination therapy of RTX (1000 mg every 3-6 months) and MMF (up to 3000 mg/day). Cardiac outcomes were evaluated during a 6-12-month follow-up period.Following the initiation of the combination therapy, consistent decreases in plasma levels of troponin T were observed in all patients (p=0.0020). Corresponding to this, left ventricular ejection fraction (LVEF) improved between 3% and 23% in five of the six patients with reduced LVEF, the rate of ventricular extrasystoles declined in all assessable patients (n=6, p=0.0313) and N-terminal pro hormone of brain natriuretic peptide decreased in six of the nine patients with elevated levels. Significant reductions in modified Rodnan skin score were also observed (p=0.0020). RTX/MMF combination was generally well tolerated. In the long-term follow-up period of up to 6 years, seven serious adverse events consisting of five infections and two fatal events were recorded.Our findings suggest that combination therapy with RTX and MMF may be an effective approach for improving refractory cardiac manifestations in patients with SSc. Controlled and prospective studies are required to further substantiate these encouraging observations and to prove the long-term safety of RTX/MMF combination.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.