Recent preclinical and clinical studies lend support to the notion that B-cell depletion is a promising therapeutic target in patients with diffuse cutaneous systemic sclerosis. A recent open-label trial provides further evidence showing marked effects of rituximab treatment on skin thickening, functional ability, and disease activity in conjunction with effects on lesional and circulating B cells and on interleukin-6 and BAFF (B-cell activating factor of tumor necrosis factor family). The excellent safety profile of rituximab in this and other trials warrants further well-designed clinical trials in larger patient groups combined with comprehensive biomarker studies.
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