{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:21:35Z","timestamp":1788351695977,"version":"build-2803163510"},"reference-count":28,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"unspecified","delay-in-days":69,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,5,5]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tocilizumab (TCZ) has shown beneficial effects on interstitial lung disease (ILD) in systemic sclerosis (SSc). We aimed to assess the real-life safety and effectiveness of TCZ on several SSc-related domains using data from a French-Italian multicentre cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of patients with SSc treated with TCZ across 15 referral centres. The following clinical data were collected at 12 months before TCZ initiation, at baseline and at 12 and 24 months of treatment: modified Rodnan skin score (mRSS), pulmonary function tests, Disease Activity Score in 28 joints using C reactive protein, digital ulcers and cardiac biomarkers. ILD progression was defined as a decline \u22655 in %predicted forced vital capacity (%pFVC) over 12\u00b13 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>197 patients were included (88% female; median age 57 years; median disease duration 9 years); 67% were antitopoisomerase I positive. TCZ monotherapy was used in 29% of cases, methotrexate was the most frequent combined treatment (35%). In SSc-associated ILD, %pFVC declined significantly from \u221212 months to baseline (81% to 77%; p=0.003). On TCZ introduction, %pFVC stabilised and the proportion of progressors declined from 43% to 24% (p=0.015). Among diffuse cutaneous patients, mRSS decreased significantly at 12 and 24 months. Digital ulcers, arthritis activity and cardiac biomarkers also improved. Infections were the most frequent adverse events (22.8%). TCZ was discontinued in 32% of patients, mainly for inefficacy. Pulmonary arterial hypertension and older age predicted TCZ failure, whereas elevated CRP predicted better response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large real-life cohort, TCZ was safe and associated with consistent benefits across different domains, supporting its role as a potential disease-modifying treatment in selected patients with SSc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006688","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T12:00:26Z","timestamp":1781006426000},"page":"e006688","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and effectiveness of tocilizumab in systemic sclerosis: a multicentre French-Italian study"],"prefix":"10.1136","volume":"12","author":[{"given":"Giulia","family":"Buonsante","sequence":"first","affiliation":[{"name":"IRCCS and INFLAGE San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy"},{"name":"Department of Rheumatology, Universit\u00e9 Paris Cit\u00e9, Cochin Institute, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"De Luca","sequence":"additional","affiliation":[{"name":"Unit of Immunology, Rheumatology, Allergy, and Rare Diseases (UnIRAR), San Raffaele Hospital, Milan, Italy"},{"name":"Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Marazzi","sequence":"additional","affiliation":[{"name":"SC Reumatologia, Universit\u00e0 di Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7479-4462","authenticated-orcid":false,"given":"Fabio","family":"Cacciapaglia","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, Universit\u00e0 degli Studi di Bari Aldo Moro, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1860-6866","authenticated-orcid":false,"given":"Maria Grazia","family":"Lazzaroni","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0947-8663","authenticated-orcid":false,"given":"Marco","family":"De Pinto","sequence":"additional","affiliation":[{"name":"Rheumatology, University of Modena and Reggio Emilia, Modena, 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