Berlin, Germany, June 7 2012: Initial results from an international, investigator-initiated, open label phase III trial were presented at EULAR 2012, the Annual Congress of the European League Against Rheumatism. Data indicate that haematopoietic stem cell transplantation (HSCT) results in better long term survival than conventional treatment for patients with poor prognosis early diffuse cutaneous systemic sclerosis.
The ASTIS (Autologous Stem Cell Transplantation International Scleroderma) trial enrolled more than 150 patients between 2001 and 2009, and randomised patients to the HSCT arm or to intravenous pulse cyclophosphamide treatment. As of May 1, 2012, significantly more deaths have occurred in the conventional treatment group. Half of the deaths in the HSCT group occurred early and were deemed treatment-related according to an independent data monitoring committee. In the conventional treatment group in contrast, none of the deaths were deemed to be treatment-related; but more deaths occurred later and most were related to progressive disease.
"Systemic sclerosis is a debilitating disease that can lead to heart, lung or kidney failure and premature death, especially in patients who have the diffuse cutaneous form of the condition, where skin thickening is more generalised and involvement of vital organs more common. The ASTIS study shows that such patients may benefit from early intensive immunosuppressive treatment," said Professor Jaap van Laar from Newcastle University, Professor Dominique Farge, Assistance Publique Hopitaux de Paris (Sponsor in France, Paris 7 University) and Professor Alan Tyndall from Basel University, on behalf of their colleagues from the EBMT EULAR Scleroderma Study Group. "These initial results are very encouraging and will help identify patients who benefit from stem cell transplantation."
The ASTIS trial was a unique collaborative project of 27 multidisciplinary teams from 10 countries conducted under the auspices of two leading organisations in the respective fields, the European Group for Blood and Marrow Transplantation (EBMT; www.ebmt.org) and the European League Against Rheumatism (EULAR;www.eular.org). The primary endpoint of the trial was event-free survival, defined as survival until death or development of major organ failure.
Systemic sclerosis is a rare but severe autoimmune systemic connective tissue disease*. Increased fibroblast activity results in abnormal growth of connective tissue which causes vascular damage and fibrosis of the skin, gastrointestinal (GI) tract and other internal organs**. Characteristics of systemic sclerosis include vasomotor disturbances; fibrosis; subsequent atrophy of the skin, subcutaneous tissue, muscles, and internal organs and immunologic disturbances*. Systemic sclerosis is estimated to occur in 2.3-10 people per one million*. Diffuse cutaneous systemic sclerosis cases make up 30% of all systemic sclerosis cases and involve the upper arms, thighs and trunk**. Lung fibrosis and pulmonary hypertension are important causes of mortality in these patients and there is no curative treatment available so far*.
Abstract Number: LB0002
*Schwartz R A. (2011) Medscape Reference: Systemic Sclerosis. [Online] Available from: http://emedicine.
** Rull G. (2011) PatientPlus: Systemic Sclerosis (Scleroderma). [Online] Available from: http://www.patient.co.uk/doctor/Systemic-Sclerosis-(Scleroderma).htm [Accessed 8 May 2012]
NOTES TO EDITORS:
For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office in Hall 6 on the 3rd floor of the Congress Centre during EULAR 2012 or on:
Candice Debleu: Onsite tel: +44 7894 386 425
The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations.
In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems.
EULAR aims to promote, stimulate and support the research, prevention, treatment and rehabilitation of rheumatic diseases. With 45 scientific member societies, 36 PARE organisations and 10 health professionals associations, EULAR underscores the importance of combating rheumatic diseases not only by medical means, but also through a wider context of care for rheumatic patients and a thorough understanding of their social and other needs.
Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer.
EULAR 2012 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 115 countries. Over the course of the congress, more than 275 oral and 1400 poster abstract presentations will be featured, with 1,010 invited speaker lectures taking place in 190 sessions.
To find out more about the activities of EULAR, visit: www.eular.org