Ten years after stem-cell transplant for systemic sclerosis, 60% remained progression-free

The edition in brief

Long-term follow-up of 80 patients who had autologous haematopoietic stem-cell transplantation for severe progressive systemic sclerosis between 2012 and 2016 found progression-free survival of 81% at 2 years, 72% at 5 and 60% at 10, with 43% in drug-free remission throughout; 6% died of transplant-related causes. In a Madrid registry of 158 patients with autoimmune-associated progressive pulmonary fibrosis, most deaths were from lung disease, and immunomodulatory treatment was associated with lower lung-related mortality (subhazard ratio 0.35), though treatment was not randomised. A single-centre series of 54 patients with antiphospholipid syndrome found rituximab sharply reduced antibody positivity at 6 to 12 months, but titres drifted back, and most recurrent thromboses occurred off anticoagulation or with low INR. In 108 women randomised to oral bisphosphonates, bone turnover markers CTX and PINP identified treatment response in 94% to 96% within three months, while bone density changes at two years were too small to separate responders reliably.