Effectiveness and safety of tocilizumab for the treatment of refractory systemic sclerosis associated interstitial lung disease: a case series

We read with great interest the results of the double-blind phase 2 faSScinate clinical trial,1 in which there was encouraging (although not statistically significant) numerical improvement in skin thickening and evidence of less decline in lung function in patients with systemic sclerosis (SSc) treated with tocilizumab (TCZ) compared with those receiving placebo. Initial investigations with TCZ in patients with SSc demonstrated improvements in skin sclerosis and polyarthritis.2 3 Scleroderma-associated interstitial lung disease (SSc-ILD) is a severely debilitating complication with high mortality in extensive disease. There is no approved disease-modifying treatment, and few effective treatment options are available. One of the most urgent needs is to determine which drugs can be useful as a rescue treatment in patients who do not respond to conventional immunosuppressants (cyclophosphamide (CYC) or mycophenolate mofetil (MMF)). In this sense, TCZ appears as one of the most promising candidates and an ongoing 2-year randomised phase 3 trial of TCZ-SC 162 mg in SSc …