Efficacy, Safety, and Tolerability of Treatments for Systemic Sclerosis-Related Interstitial Lung Disease: A Systematic Review and Network Meta-Analysis

Gian Luca Erre, Marco Sebastiani, Maria Antonietta Fenu, Angelo Zinellu, Alberto Floris, Lorenzo Cavagna, Elisabetta Renzoni, Andreina Manfredi, Giuseppe Passiu, Richard John Woodman, Arduino Aleksander Mangoni

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND: There is a paucity of head-to-head comparisons of the efficacy and harms of pharmacological treatments for systemic sclerosis-related interstitial lung disease (SSc-ILD).

METHODS: We conducted a network meta-analysis (NMA) in order to compare the effects of different treatments with the placebo on change in forced vital capacity (FVC), change in diffusion lung capacity for CO (DLCO), serious adverse events (SAEs), discontinuation for adverse events and mortality in SSc-ILD. Standardized mean difference (SMD) and log odds ratio were estimated using NMA with fixed effects.

RESULTS: Nine randomized clinical trials (926 participants) comparing eight interventions and the placebo for an average follow-up of one year were included. Compared to the placebo, only rituximab significantly reduced FVC decline (SMD (95% CI) = 1.00 (0.39 to 1.61)). Suitable data on FVC outcome for nintedanib were not available for the analysis. No treatments influenced DLCO. Safety and mortality were also not different across treatments and the placebo, although there were few reported events. Cyclophosphamide and pomalidomide were less tolerated than the placebo, mycophenolate, and nintedanib.

CONCLUSION: Only rituximab significantly reduced lung function decline compared to the placebo. However, direct head-to-head comparison studies are required to confirm these findings and to better determine the safety profile of various treatments.

Original languageEnglish
JournalJournal of Clinical Medicine
Volume9
Issue number8
DOIs
Publication statusPublished - Aug 7 2020

Fingerprint Dive into the research topics of 'Efficacy, Safety, and Tolerability of Treatments for Systemic Sclerosis-Related Interstitial Lung Disease: A Systematic Review and Network Meta-Analysis'. Together they form a unique fingerprint.

Cite this