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Now showing items 1 - 16 of 34
Solmaz, Dilek Bakirci, Sibel Kimyon, Gezmis Kasapoglu Gunal, Esen Dogru, Atalay Bayindir, Ozun Dalkilic, Ediz Ozisler, Cem Can, Meryem Akar, Servet Cetin, Gozde Yildirim Yavuz, Sule Kilic, Levent Tarhan, Emine Figen Kucuksahin, Orhan Omma, Ahmet Gonullu, Emel Yildiz, Fatih Ersozlu, Emine Duygu Cinar, Muhammet Onazi, Atallah Aydin Tufan, Muge Erden, Abdulsamet Yilmaz, Sema Pehlevan, Seval Kalyoncu, Umut Aydin, Sibel Zehra
Aydin, Sibel Zehra Filippucci, Emilio Atagündüz, Pamir Yavuz, Sule Grassi, Walter Direskeneli, Haner
Outcomes of patients with systemic sclerosis treated with rituximab in contemporary practice: a prospective cohort study
Elhai, Muriel Boubaya, Marouane Distler, Oliver Smith, Vanessa Matucci-Cerinic, Marco Alegre Sancho, Juan José Truchetet, Marie-Elise Braun-Moscovici, Yolanda Iannone, Florenzo Novikov, Pavel I Lescoat, Alain Siegert, Elise Castellví, Ivan Airó, Paolo Vettori, Serena De Langhe, Ellen Hachulla, Eric Erler, Anne Ananieva, Lidia Krusche, Martin López-Longo, F J Distler, Jörg H W Hunzelmann, Nicolas Hoffmann-Vold, Anna-Maria Riccieri, Valeria Hsu, Vivien M Pozzi, Maria R Ancuta, Codrina Rosato, Edoardo Mihai, Carina Kuwana, Masataka Saketkoo, Lesley Ann Chizzolini, Carlo Hesselstrand, Roger Ullman, Susanne Yavuz, Sule Rednic, Simona Caimmi, Cristian Bloch-Queyrat, Coralie Allanore, Yannick
Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseases.
Yilmaz, Neslihan Emmungil, Hakan Gucenmez, Sercan Ozen, Gulsen Yildiz, Fatih Balkarli, Ayse Kimyon, Gezmis Coskun, Belkis Nihan Dogan, Ismail Pamuk, Omer Nuri Yasar, Sule Cetin, Gozde Yildirim Yazici, Ayten Ergulu Esmen, Serpil Cagatay, Yonca Yilmaz, Sema Cefle, Ayse Sayarlioglu, Mehmet Kasifoglu, Timucin Karadag, Omer Pehlivan, Yavuz Dalkilic, Ediz Kisacik, Bunyamin Cobankara, Veli Erken, Eren Direskeneli, Haner Aksu, Kenan Yavuz, SuleOBJECTIVE: To assess bladder toxicity of cyclophosphamide (CYC) and uroprotective effect of mesna in rheumatic diseases.; METHODS: Data of 1018 patients (725 women/293 men) treated with CYC were evaluated in this retrospective study. All of the following information was obtained: the cumulative CYC dose, route of CYC administration, duration of therapy, concomitant mesna usage, and hemorrhagic cystitis. Cox proportional hazard model was used for statistics.; RESULTS: We identified 17 patients (1.67%) with hemorrhagic cystitis and 2 patients (0.19%) with bladder cancer in 4224 patient-years. The median time for diagnosis to hemorrhagic cystitis was 10 months (4-48) and bladder cancer was 8 years (6-10.9). There were 583 patients (57.2%) who received mesna with intravenous CYC therapy. We observed similar incidence rate for hemorrhagic cystitis in both patient groups concomitantly treated with or without mesna [9/583 (1.5%) vs 8/425 (1.8%) respectively, p =3D 0.08]. Cumulative CYC dose (HR for 10-g increments 1.24, p < 0.001) was associated with hemorrhagic cystitis.; CONCLUSION: Cumulative dose was the only risk factor for hemorrhagic cystitis in patients treated with CYC. No proof was obtained for the uroprotective effect of mesna in our cohort.=20
A common SNP in the CD40 region is associated with systemic lupus erythematosus and correlates with altered CD40 expression:implications for the pathogenesis
Vazgiourakis, Vassilios M. Zervou, Maria I. Choulaki, Christianna Bertsias, George Melissourgaki, Maria Yilmaz, Neslihan Sidiropoulos, Prodromos Plant, Darren Trouw, Leendert A. Toes, Rene E. Kardassis, Dimitris Yavuz, Sule Boumpas, Dimitrios T. Goulielmos, George N.Background In systemic lupus erythematosus (SLE) sustained CD40L expression by T cells and platelets activates a variety of cells via its receptor CD40 contributing to disease pathogenesis. Although CD40 has recently been identified in genome-wide association study as a novel rheumatoid arthritis susceptibility gene such an association has not been documented for SLE. Objective To investigate whether the rs4810485 CD40 single nucleotide polymorphism (SNP) is associated with increased risk for SLE and its impact on CD40 expression. Materials and methods The primary sample set consisted of 351 patients with SLE and 670 matched healthy controls of Greek origin. 158 patients with SLE and 155 controls from Turkey were used as a replication sample. Genotyping of rs4810485 was performed by restriction fragment length polymorphism and the Sequenom MassArray technology. The expression of CD40 mRNA and protein was assessed in unstimulated and lipopolysaccharide-stimulated peripheral blood mononuclear cells by quantitative real time PCR and flow cytometry, respectively. Results The minor allele T of CD40 rs4810485 SNP was significantly under-represented in Greek patients with SLE compared with healthy controls (OR=3D0.65, 95% CI 0.54 to 0.79). The association was replicated in the Turkish cohort (OR=3D0.57, 95% CI 0.41 to 0.80; meta-analysis of 509 patients with SLE and 825 healthy controls: OR=3D0.63, 95% CI 0.53 to 0.74, p =3D 2x10(-8)). In both cases and controls, the rs4810485 G/T and T/T genotypes were associated with significantly reduced CD40 mRNA and protein expression in peripheral blood CD14+ monocytes and CD19+ B cells compared with G/G genotype, both under basal conditions and following stimulation. Conclusions CD40 has been identified as a new susceptibility locus in Greek and Turkish patients with SLE. The rs4810485 minor allele T is under-represented in SLE and correlates with reduced CD40 expression in peripheral blood monocytes and B cells, with potential implications for the regulation of aberrant immune responses in the disease.
Onat, Ahmet Mesut Fernandez-Aranguren, Tamara Serrano-Fernandez, Alberto Robledo, Gema Direskeneli, Haner Sawalha, Amr H. Yavuz, Sule Martin, JavierObjective. To evaluate the genetic background of systemic sclerosis ( SSc) in the Turkish population.Methods. There were 354 cases and 718 unaffected controls from Turkey genotyped for the most relevant SSc genetic markers ( IRF5-rs10488631, STAT4-rs3821236, CD247-rs2056626, DNASE1L3-rs35677470, IL12A-rs77583790, and ATG5-rs9373839). Association tests were conducted to identify possible associations.Results. Except for ATG5, all the analyzed genes showed either significant associations ( IRF5: p =3D 1.32E-05, OR 1.76; CD247: p =3D 2.20E-03, OR 0.75) or trends of association ( STAT4: p =3D 0.066, OR 1.21; IL12A: p =3D 0.079, OR 4.07; DNASE1L3: p =3D 0.097, OR 1.41) with the overall disease or with specific phenotypes.Conclusion. The genetic component of SSc seems to be similar between Turks and Europeans.
Comparative characteristics of mu chain and alpha chain transcripts expressed by individual tonsil plasma cells
Yavuz, Sule Grammer, Amrie C. Yavuz, A. Selim Nanki, Toshihiro Lipsky, Peter E.Plasma cells (PCs) are one of the two major cell types generated during germinal center reactions. To test the hypothesis that PCs express a unique repertoire of immunoglobulin (Ig) genes resulting from intensive antigenic stimulation and selection, the mutational pattern and distribution of VH gene segments within 178 transcripts amplified from individual IgM and IgA secreting tonsil PCs were analyzed. The results demonstrated that both mu and alpha transcripts expressed repertoires with limited diversity. Moreover, both mu and alpha transcripts were heavily mutated, with a significantly increased mutational frequency noted for alpha compared to mu transcripts (5.0X10-2 vs 1.8X10-2, P<0.001). In addition, both mu and alpha transcripts showed significantly greater targeting of mutations to RGYW motifs (purine/guanine/pyrimidine/A or T) compared to memory B cells. Finally, clonally expanded cells were detected in alpha but not mu PC compartments. These results indicate that antigen driven stimulation and selection shape the entire expressed PC repertoire, but the impact is greater in alpha expressing PCs.
Aydin, Sibel Zehra Kucuksahin, Orhan Kilic, Levent Dogru, Atalay Bayindir, Ozun Ozisler, Cem Omma, Ahmet Tarhan, Emine Figen Erden, Abdulsamet Kimyon, Gezmis Can, Meryem Dalkilic, Ediz Yavuz, Sule Ureyen, Sibel Bakirci Gunal, Esen Kasapoglu Alhussain, Fatima Arslan Akyol, Lutfi Balkarli, Ayse Yilmaz, Sema Cinar, Muhammet Aydin, Muge Tufan Solmaz, Dilek Mercan, Ridvan Erten, Sukran Kalyoncu, UmutPsoriatic arthritis (PsA) may affect different joints, including the spine. The prevalence of spinal involvement is variable depending on the definition and a subset of patients have been identified in cohorts that do not have clinical features of axial disease and yet have imaging findings. Still, there is not a consensus on how and when to screen axial disease. In this study, we aimed to investigate factors associated with being underdiagnosed for axial psoriatic arthritis (axPsA) and its impacts on outcomes. Disease features and outcomes of axPsA according to the physician (n=3D415) were compared with patients with imaging findings only (sacroiliitis fulfilling the modified New York criteria, n=3D112), using data from a real-life PsA registry. Patients with imaging findings only were more frequently women (83/220 (37.7%) vs 29/122 (23.8%); p=3D0.008). This group also had higher peripheral disease activity (imaging only vs clinical AxPsA: mean (SD) tender joint count 5.3 (6.1) vs 3.3 (4.7), swollen joint count 1.9 (2.9) vs 1.2 (2.4); p<0.001 for both comparisons) and was less often treated using TNF inhibitors (16.1 vs 38.2%; p<0.001) than patients who were classified as axPsA. Patient-reported outcomes were similar in both groups. PsA patients, especially women with more severe peripheral disease, have a higher risk of being underdiagnosed for axPsA. The severity of peripheral symptoms may be a risk factor to mask the spinal features of PsA.=20
TRAF1/C5, eNOS, C1q, but not STAT4 and PTPN22 gene polymorphisms are associated with genetic susceptibility to systemic lupus erythematosus in Turkey
Zervou, Maria I. Vazgiourakis, Vassilios M. Yilmaz, Neslihan Kontaki, Elena Trouw, Leendert A. Toes, Rene E. Bicakcigil, Muge Boumpas, Dimitrios T. Yavuz, Sule Goulielmos, George N.A significant source of variability in the literature on systemic lupus erythematosus (SLE) susceptibility genes has been the inability to replicate genetic findings across different racial or ethnic groups. We investigated whether a single nucleotide polymorphism (SNP) of the STAT4 (rs7574865), PTPN22 (rs2476601), TRAF1/C5 (rs10818488), and C1q (rs292001) genes as well as the 27-bp VNTR polymorphism on intron 4 of eNOS, previously associated with SLE in other populations, are also associated with SLE risk in Turkey. A group of 158 SLE patients and 155 healthy controls were included in this study. A genetic association of the TRAF1/C5, C1q, and eNOS gene polymorphism, but not of STAT4 and PTPN22, was found to confer a degree of risk for SLE. These data highlight the importance of comparative studies in different populations to confirm the previously detected genetic associations. (C) 2011 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.
Yilmaz, Neslihan Abul, Yasin Bicakcigil, Muge Golabi, Pejman Celikel, Cigdem Karakurt, Sait Yavuz, SuleInducted sputum (IS) is a non-invasive procedure that can be used for collection of airway secretions. The aim of our study is to evaluate the clinical usefulness of IS for detection of airway inflammation in systemic sclerosis (SSc). Bronchoalveolar lavage and IS were performed to 20 patients with SSc. Eighteen patients who were referred to pulmonary medicine for bronchoalveolar lavage due to other reasons were also recruited for cell counts comparisons. Spirometry, echocardiography and thorax CT (HRCT) imaging were also performed to all patients. Mean macrophage and lymphocyte counts were found to be increased in IS of SSc patients compared with that of control (58.4 =C2=B1 14.5% vs. 31.3 =C2=B1 16.3%, 30.2 =C2=B1 15.4% vs. 15.0 =C2=B1 11.5% P < 0.001), whereas mean neutrophil count was lower in the SSc patients (4.1 =C2=B1 4.5% vs. 17.2 =C2=B1 13.1%, P < 0.05). Significant correlations were noted between BAL and IS findings for macrophage (r =3D 0.55, P =3D 0.02) lymphocyte (r =3D 0.65, P < 0.01) and total cell counts (r =3D 0.45, P =3D 0.06). IS is an easy and reliable method for the detection of alveolitis and can be used for early detection of lung involvement in scleroderma.=20
Elhai, Muriel Meune, Christophe Boubaya, Marouane Avouac, Jerome Hachulla, Eric Balbir-Gurman, Alexandra Riemekasten, Gabriela Airo, Paolo Joven, Beatriz Vettori, Serena Cozzi, Franco Ullman, Susanne Czirjak, Laszlo Tikly, Mohammed Mueller-Ladner, U. L. F. Caramaschi, Paola Distler, Oliver Iannone, Florenzo Ananieva, Lidia P. Hesselstrand, Roger Becvar, Radim Gabrielli, Armando Damjanov, Nemanja Salvador, Maria J. Riccieri, Valeria Mihai, Carina Szucs, Gabriella Walker, Ulrich A. Hunzelmann, Nicolas Martinovic, Duska Smith, Vanessa Mueller, Carolina de Souza Montecucco, Carlo Maurizio Opris, Daniela Ingegnoli, Francesca Vlachoyiannopoulos, Panayiotis G. Stamenkovic, Bojana Rosato, Edoardo Heitmann, Stefan Distler, Joerg H. W. Zenone, Thierry Seidel, Matthias Vacca, Alessandra De langhe, Ellen Novak, Srdan Cutolo, Maurizio Mouthon, Luc Henes, Joerg Chizzolini, Carlo von Muhlen, Carlos Alberto Solanki, Kamal Rednic, Simona Stamp, Lisa Anic, Branimir Santamaria, Vera Ortiz De Santis, Maria Yavuz, Sule Alberto Sifuentes-Giraldo, Walter Chatelus, Emmanuel Stork, Jiri van Laar, Jacob Loyo, Esthela de la Pena Lefebvre, Paloma Garcia Eyerich, Kilian Cosentino, Vanesa Jose Alegre-Sancho, Juan Kowal-Bielecka, Otylia Rey, Gregoire Matucci-Cerinic, Marco Allanore, YannickObjectives To determine the causes of death and risk factors in systemic sclerosis (SSc). Methods Between 2000 and 2011, we examined the death certificates of all French patients with SSc to determine causes of death. Then we examined causes of death and developed a score associated with all-cause mortality from the international European Scleroderma Trials and Research (EUSTAR) database. Candidate prognostic factors were tested by Cox proportional hazards regression model by single variable analysis, followed by a multiple variable model stratified by centres. The bootstrapping technique was used for internal validation. Results We identified 2719 French certificates of deaths related to SSc, mainly from cardiac (31%) and respiratory (18%) causes, and an increase in SSc-specific mortality over time. Over a median follow-up of 2.3 years, 1072 (9.6%) of 11 193 patients from the EUSTAR sample died, from cardiac disease in 27% and respiratory causes in 17%. By multiple variable analysis, a risk score was developed, which accurately predicted the 3-year mortality, with an area under the curve of 0.82. The 3-year survival of patients in the upper quartile was 53%, in contrast with 98% in the first quartile. Conclusion Combining two complementary and detailed databases enabled the collection of an unprecedented 3700 deaths, revealing the major contribution of the cardiopulmonary system to SSc mortality. We also developed a robust score to risk-stratify these patients and estimate their 3-year survival. With the emergence of new therapies, these important observations should help caregivers plan and refine the monitoring and management to prolong these patients' survival.
Two-year experience with mycophenolate mofetil in patients with scleroderma lung disease: a case series.
Yilmaz, Neslihan Can, Meryem Kocakaya, Derya Karakurt, Sait Yavuz, SuleTo assess the effect of mycophenolate mofetil (MMF) on pulmonary functions in patients with systemic sclerosis-associated lung disease (SSc-ILD) who experienced an inadequate response to first line cyclophosphamide (CYC) therapy. Twelve consecutive SSc-ILD patients who received MMF due to inadequate response to CYC as a first line agent, were retrospectively reviewed. Over the course of 2 years, pulmonary function tests (PFT) and high-resolution computed tomography (HRCT) scans were performed. Following initial baseline tests, PFTs were continued at a frequency of every 6 months and HRCT scans were performed every 12 months. After MMF treatment, values of forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) improved in three (25%) and two (16.6%) patients, respectively. It is also noted that the evaluation of serial HCRT scans showed no change in 54.5% of patients. Our case series suggested that PFT and imaging scores seemed to be stabilized by MMF in SSc-ILD patients who were inadequate responders to CYC. =C2=A9 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
Htoon, Jasmine Nadig, Ajay Hughes, Travis Yavuz, Sule Direskenel, Haner Saruhan-Direskeneli, Guher Sawalha, Amr H.
Rituximab for Remission Induction in a Patient with Relapsing Necrotizing Scleritis Associated with Limited Wegener's Granulomatosis
Onal, Sumru Kazokoglu, Haluk Koc, Aylin Yavuz, SulePurpose: The authors report a case of necrotizing scleritis associated with Wegener's granulomatosis (WG), which was treated with rituximab for relapsing disease. Method: Observational case report. Results: A 32-year-old male patient presented with necrotizing scleritis in his left eye. The patient was diagnosed as having limited WG. Cyclophosphamide was begun. Under maintenance treatment with azathioprine two relapses of scleritis occurred. Since a high cumulative dose of cyclophosphamide (22.5 g) was utilized initially, two intravenous infusions of rituximab 1 g was given. Complete resolution of scleritis occurred. Conclusions: Rituximab may be effective to induce remission in patients with scleritis due to WG.
Predictors of disease worsening defined by progression of organ damage in diffuse systemic sclerosis:a European Scleroderma Trials and Research (EUSTAR) analysis
Becker, Mike Graf, Nicole Sauter, Rafael Allanore, Yannick Curram, John Denton, Christopher P. Khanna, Dinesh Matucci-Cerinic, Marco Pena, Janethe de Oliveira Pope, Janet E. Matucci-Cerinic, Marco Guiducci, Serena Walker, Ulrich Jaeger, Veronika Bannert, Bettina Lapadula, Giovanni Becvarare, Radim Cutolo, Maurizio Valentini, Gabriele Siegert, Elise Rednic, Simona Allanore, Yannick Montecucco, C. Carreira, Patricia E. Novak, Srdan Czirjak, Laszlo Varju, Cecilia Chizzolini, Carlo Allai, Daniela Kucharz, Eugene J. Cozzi, Franco Rozman, Blaz Mallia, Carmel Gabrielli, Armando Bancel, Dominique Farge Airo, Paolo Hesselstrand, Roger Martinovic, Duska Balbir-Gurman, Alexandra Braun-Moscovici, Yolanda Hunzelmann, Nicolas Pellerito, Raffaele Caramaschi, Paola Black, Carol Damjanov, Nemanja Henes, Joerg Ortiz Santamaria, Vera Heitmann, Stefan Seidel, Matthias Pereira Da Silva, Jose Antonio Stamenkovic, Bojana Selmi, Carlo Francesco Tikly, Mohammed Denisov, Lev N. Mueller-Ladner, Ulf Engelhart, Merete Hachulla, Eric Riccieri, Valeria Ionescu, Ruxandra Maria Mihai, Carina Sunderkoetter, Cord Kuhn, Annegret Schett, Georg Distler, Joerg Meroni, Pierluigi Ingegnoli, Francesca Mouthon, Luc De Keyser, Filip Smith, Vanessa Cantatore, Francesco Paolo Corrado, Ada Ullman, Susanne Iversen, Line Pozzi, Maria Rosa Eyerich, Kilian Hein, Ruediger Knott, Elisabeth Wiland, Piotr Szmyrka-Kaczmarek, Magdalena Sokolik, Renata Morgiel, Ewa Madej, Marta Jose Alegre-Sancho, Juan Krummel-Lorenz, Brigitte Saar, Petra Aringer, Martin Guenther, Claudia Anne, Erler Westhovens, Rene De langhe, Ellen Lenaerts, Jan Anic, Branimir Baresic, Marko Mayer, Miroslav Uprus, Maria Otsa, Kati Yavuz, Sule Radominski, Sebastiao Cezar Mueller, Carolina de Souza Azevedo, Valderilio Feijo Popa, Sergei Zenone, Thierry Stebbings, Simon Highton, John Mathieu, Alessandro Vacca, Alessandra Stamp, Lisa Chapman, Peter O'Donnell, John Solanki, Kamal Doube, Alan Veale, Douglas O'Rourke, Marie Loyo, Esthela Li, Mengtao Rosato, Edoardo Amoroso, Antonio Gigante, Antonietta Oksel, Fahrettin Yargucu, Figen Tanaseanu, Cristina-Mihaela Popescu, Monica Dumitrascu, Alina Tiglea, Isabela Foti, Rosario Visalli, Elisa Benenati, Alessia Amato, Giorgio Ancuta, Codrina Chirieac, Rodica Villiger, Peter Adler, Sabine Dan, Diana de la Pena Lefebvre, Paloma Garcia Rodriguez Rubio, Silvia Valero Exposito, Marta Sibilia, Jean Chatelus, Emmanuel Gottenberg, Jacques Eric Chifflot, Helene Litinsky, Ira Del Galdo, Francesco Venalis, Algirdas Saketkoo, Lesley Ann Lasky, Joseph A. Kerzberg, Eduardo Montoya, Fabiana Cosentino, Vanesa Limonta, Massimiliano Brucato, Antonio Luca Lupi, Elide Spertini, Francois Ribi, Camillo Buss, Guillaume Martin, Thierry Guffroy, Aurelien Poindron, Vincent Chung, Lori Schmeiser, Tim Zebryk, Pawel Riso, Nuno Riemekasten, Gabriela Rezus, Elena Puttini, Piercarlo SarziObjectives Mortality and worsening of organ function are desirable endpoints for clinical trials in systemic sclerosis (SSc). The aim of this study was to identify factors that allow enrichment of patients with these endpoints, in a population of patients from the European Scleroderma Trials and Research group database.Methods Inclusion criteria were diagnosis of diffuse SSc and follow-up over 12 +/- 3 months. Disease worsening/organ progression was fulfilled if any of the following events occurred: new renal crisis; decrease of lung or heart function; new echocardiography-suspected pulmonary hypertension or death. In total, 42 clinical parameters were chosen as predictors for the analysis by using (1) imputation of missing data on the basis of multivariate imputation and (2) least absolute shrinkage and selection operator regression.Results Of 1451 patients meeting the inclusion criteria, 706 had complete data on outcome parameters and were included in the analysis. Of the 42 outcome predictors, eight remained in the final regression model. There was substantial evidence for a strong association between disease progression and age, active digital ulcer (DU), lung fibrosis, muscle weakness and elevated C-reactive protein (CRP) level. Active DU, CRP elevation, lung fibrosis and muscle weakness were also associated with a significantly shorter time to disease progression. A bootstrap validation step with 10 000 repetitions successfully validated the model.Conclusions The use of the predictive factors presented here could enable cohort enrichment with patients at risk for overall disease worsening in SSc clinical trials.
Outcomes of patients with systemic sclerosis treated with rituximab in contemporary practice:a prospective cohort study
Elhai, Muriel Boubaya, Marouane Distler, Oliver Smith, Vanessa Matucci-Cerinic, Marco Alegre Sancho, Juan Jose Truchetet, Marie-Elise Braun-Moscovici, Yolanda Iannone, Florenzo Novikov, Pavel I. Lescoat, Alain Siegert, Elise Castellvi, Ivan Airo, Paolo Vettori, Serena De Langhe, Ellen Hachulla, Eric Erler, Anne Ananieva, Lidia Krusche, Martin Lopez-Longo, F. J. Distler, Joerg H. W. Hunzelmann, Nicolas Hoffmann-Vold, Anna-Maria Riccieri, Valeria Hsu, Vivien M. Pozzi, Maria R. Ancuta, Codrina Rosato, Edoardo Mihai, Carina Kuwana, Masataka Saketkoo, Lesley Ann Chizzolini, Carlo Hesselstrand, Roger Ullman, Susanne Yavuz, Sule Rednic, Simona Caimmi, Cristian Bloch-Queyrat, Coralie Allanore, Yannick Guiducci, Serena Walker, Ulrich A. Kyburz, Diego Lapadula, Giovanni Maurer, Britta Jordan, Suzana Dobrota, Rucsandra Becvar, Radim Sierakowsky, Stanislaw Bielecka, Otylia Kowal Sulli, Alberto Cutolo, Maurizio Cuomo, Giovanna Nicoara, Ileana Kahan, Andre Vlachoyiannopoulos, Panayiotis G. Montecucco, Carlo Maurizio Caporali, Roberto Stork, Jiri Inanc, Murat Carreira, Patricia E. Novak, Srdan Czirjak, Laszlo Varju, Cecilia Kucharz, Eugene J. Kotulska, Anna Kopec-Medrek, Magdalena Widuchowska, Malgorzata Cozzi, Franco Rozman, Blaz Mallia, Carmel Coleiro, Bernard Gabrielli, Armando Farge, Dominique Wu, Chen Marjanovic, Zora Faivre, Helene Hij, Darin Dhamadi, Roza Wollheim, Frank Scheja, Agneta Wuttge, Dirk M. Andreasson, Kristofer Martinovic, Duska Balbir-Gurman, Alexandra Trotta, F. Lo Monaco, Andrea Pellerito, Raffaele Mauriziano, Ospedale Caramaschi, Paola Morovic-Vergles, Jadranka Black, Carol Denton, Christopher Damjanov, Nemanja Henes, Jorg Santamaria, Vera Ortiz Heitmann, Stefan Krasowska, Dorota Matthias Hasler, Paul Burkhardt, Harald Himsel, Andrea Bajocchi, Gianluigi Da Silva, Jose Antonio Pereira Salvador, Maria Joao Stamenkovic, Bojana Stankovic, Aleksandra Selmi, Carlo Francesco De Santis, Maria Tikly, Mohammed Denisov, Lev N. Herrick, Ariane Mueller-Ladner, Ulf Frerix, Marc Tarner, Ingo Scorza, Raffaella Puppo, Francesco Engelhart, Merete Strauss, Gitte Nielsen, Henrik Damgaard, Kirsten Szucs, Gabriela Mendoza, Antonio Zea de la Puente, Carlos Giraldo, Sifuentes W. A. Midtvedt, Oyvind Reiseter, Silje Garen, Torhild Launay, David Valesini, Guido Ionescu, Ruxandra Maria Groseanu, Laura Opris, Daniela Cornateanu, Roxana Sfrent Ionitescu, Razvan Gherghe, Ana Maria Soare, Alina Gorga, Marilena Bojinca, Mihai Milicescu, Mihaela Sunderkotter, Cord Kuhn, Annegret Sandorfi, Nora Schett, Georg Beyer, Christian Meroni, Pierluigi Ingegnoli, Francesca Mouthon, Luc De Keyser, Filip Melsens, Karin Cantatore, Francesco P. Corrado, Ada Iversen, Line von Muhlen, Carlos Alberto Bohn, Jussara Marilu Lonzetti, Lilian Scussel Eyerich, Kilian Hein, Rudiger Knott, Elisabeth Wiland, Piotr Szmyrka-Kaczmarek, Magdalena Sokolik, Renata Morgiel, Ewa Madej, Marta Houssiau, Frederic A. Krummel-Lorenz, Brigitte Saar, Petra Aringer, Martin Gunther, Claudia Westhovens, Rene Lenaerts, Jan Anic, Branimir Baresic, Marko Mayer, Miroslav Uprus, Maria Otsa, Kati Granel, Brigitte Muller, Carolina de Souza Radominski, Sebastiao C. Azevedo, Valderilio F. Jimenez, Sergio Busquets, Joanna Agachi, Svetlana Groppa, Liliana Chiaburu, Lealea Russu, Eugen Popa, Sergei Zenone, Thierry Pileckyte, Margarita Mathieu, Alessandro Vacca, Alessandra Sampaio-Barros, Percival D. Yoshinari, Natalino H. Marangoni, Roberta G. Martin, Patricia Fuocco, Luiza Stebbings, Simon Highton, John Chapman, Peter O'Donnell, John Stamp, Lisa Doube, Alan Solanki, Kamal Veale, Douglas O'Rourke, Marie Loyo, Esthela Li, Mengtao Mohamed, Walid Ahmed Abdel Atty Amoroso, Antonio Gigante, Antonietta Oksel, Fahrettin Yargucu, Figen Tanaseanu, Cristina-Mihaela Popescu, Monica Dumitrascu, Alina Tiglea, Isabela Foti, Rosario Chirieac, Rodica Furst, Daniel Villiger, Peter Adler, Sabine van Laar, Jacob Kayser, Cristiane Fathi, Nihal Hassanien, Manal Lefebvre, Paloma Garcia de la Pena Rubio, Silvia Rodriguez Exposito, Marta Valero Chatelus, Emmanuel Sibilia, Jean Gottenberg, Jacques Eric Chifflot, Helene Litinsky, Ira Emery, Paul Buch, Maya Del Galdo, Francesco Venalis, Algirdas Butrimiene, Irena Venalis, Paulius Rugiene, Rita Karpec, Diana Lasky, Joseph A. Cosentino, Vanesa Kerzberg, Eduardo Montoya, Fabiana Bianchi, Washington Carneiro, Sueli Maretti, Giselle Baptista Bianchi, Dante Valdetaro Limonta, Massimiliano Brucato, Antonio Luca Lupi, Elide Rosner, Itzhak Rozenbaum, Michael Slobodin, Gleb Boulman, Nina Rimar, Doron Couto, Maura Kahl, Sarah Chen, Fei McCloskey, Deborah Malveaux, Halina Spertini, Francois Ribi, Camillo Buss, Guillaume Martin, Thierry Guffroy, Aurelien Poindron, Vincent Chotchaeva, Fatima Mukhin, Nikolay A. Moiseev, SergeyObjective To assess the safety and efficacy of rituximab in systemic sclerosis (SSc) in clinical practice. Methods We performed a prospective study including patients with SSc from the European Scleroderma Trials and Research (EUSTAR) network treated with rituximab and matched with untreated patients with SSc. The main outcomes measures were adverse events, skin fibrosis improvement, lung fibrosis worsening and steroids use among propensity score-matched patients treated or not with rituximab. Results 254 patients were treated with rituximab, in 58% for lung and in 32% for skin involvement. After a median follow-up of 2 years, about 70% of the patients had no side effect. Comparison of treated patients with 9575 propensity-score matched patients showed that patients treated with rituximab were more likely to have skin fibrosis improvement (22.7 vs 14.03 events per 100 person-years; OR: 2.79 [1.47-5.32]; p=3D0.002). Treated patients did not have significantly different rates of decrease in forced vital capacity (FVC)>10% (OR: 1.03 [0.55-1.94]; p=3D0.93) nor in carbon monoxide diffusing capacity (DLCO) decrease. Patients having received rituximab were more prone to stop or decrease steroids (OR: 2.34 [1.56-3.53], p<0.0001). Patients treated concomitantly with mycophenolate mofetil had a trend for better outcomes as compared with patients receiving rituximab alone (delta FVC: 5.22 [0.83-9.62]; p=3D0.019 as compared with controls vs 3 [0.66-5.35]; p=3D0.012). Conclusion Rituximab use was associated with a good safety profile in this large SSc-cohort. Significant change was observed on skin fibrosis, but not on lung. However, the limitation is the observational design. The potential stabilisation of lung fibrosis by rituximab has to be addressed by a randomised trial.