Early Initiation of Tocilizumab May Preserve Lung Function in SSc-ILD

Early identification of interstitial lung disease (ILD), followed by subsequent tocilizumab therapy initiation, may preserve lung function in patients with systemic sclerosis (SSc)-associated ILD (SSc-ILD) with elevated inflammatory markers. This is according to research results presented at the American Thoracic Society (ATS) 2021 International Conference, held virtually from May 14 to May 19, 2021.

Researchers presented post hoc data from a multicenter, randomized, double-blind, placebo-controlled phase 3 study (ClincialTrials.gov Identifier: NCT02453256), which included adult patients with SSc for 60 or fewer months. Participants had a modified Rodnan skin score of 10 to 35 units at screening, as well as elevated acute-phase reactant levels at baseline. Participants were randomly assigned 1:1 to receive either weekly subcutaneous tocilizumab 162 mg injections or placebo over a period of 48 weeks.

The total cohort included 136 patients with baseline SSc-ILD (placebo, 68; tocilizumab, 68). Within the tocilizumab group, 49.2% did not experience any decrease in percent-predicted forced vital capacity (FVC), compared with 25% of patients in the placebo group. Patients in the tocilizumab group were also less likely to experience a ≥10% ppFVC decrease and more likely to experience a ≥10% ppFVC increase vs placebo (8.5% vs 25% and 10.2% vs 1.8%, respectively).

Within the placebo group, 10.7% of participants experienced a severe decrease in absolute FVC (decrease, 25%-25%) vs no patients in the tocilizumab group; more patients in that group experienced a ≥5% FVC increase vs baseline (25.4% vs 5.4%).

“Results from this 48-week study suggest that early identification of ILD and initiation of tocilizumab treatment may help preserve lung function in patients with SSc-ILD and elevated inflammatory markers,” the researchers concluded. “In addition, tocilizumab may help restore lung function in some patients.”

Reference

Khanna D, Lin CJF, Furst DE, et al. Preservation of lung function with tocilizumab in patients with systemic sclerosis interstitial lung disease: analysis from the double-blind period of a phase 3 trial. Presented at: the American Thoracic Society (ATS) 2021 Annual Meeting; May 14-19, 2021. Abstract A1808.