Successful experience with divozilimab therapy for systemic sclerosis

Abstract

Systemic sclerosis (SSc) is a severe rheumatic disease characterized by high mortality and reduced quality of life. Over the past 10–15 years, the treatment paradigm for SSc has changed dramatically owing to a better understanding of its pathogenesis, the accumulation of evidence supporting the efficacy of immunosuppressants, and the emergence of targeted therapies. B lymphocytes are considered to play a key role in disease development through their effects on fibroblast activation and autoantibody production, making anti-B-cell therapy pathogenetically justified. A clinical case of successful treatment of diffuse SSc resistant to standard immunosuppression with the novel Russian anti-B-cell agent divozilimab (DIV) is presented. Therapy resulted in complete regression of skin fibrosis, with the skin score decreasing from 15 to 0 points, and signs of neoangiogenesis were documented by capillaroscopy. The drug was well tolerated. This observation indicates the potential efficacy of DIV in resistant forms of SSc.