TY - JOUR T1 - Upfront Combination Therapy With Rituximab and Mycophenolate Mofetil for Progressive Systemic Sclerosis JF - The Journal of Rheumatology JO - J Rheumatol SP - 304 LP - 305 DO - 10.3899/jrheum.200484 VL - 48 IS - 2 AU - Doron Rimar AU - Itzhak Rosner AU - Gleb Slobodin Y1 - 2021/02/01 UR - http://www.jrheum.org/content/48/2/304.abstract N2 - To the Editor:Systemic sclerosis (SSc) is a complex disease involving multiple pathophysiological pathways: autoimmunity, vasculopathy, and fibrosis, all of which are interrelated. Most of the damage consists of skin and lung fibrosis, and is accumulated within the first 2 years of disease in rapidly progressive patients with a serology of anti-SCL-70 or anti–RNA polymerase III (RNAP3)1. Indeed, this group of patients carry a great risk of morbidity and excess mortality. A combination “induction” therapy at an early stage—a window of opportunity—in which it is still possible to change the course of disease in this group of patients, is logical. We report herein our recent experience with early upfront combination therapy for progressive SSc, directed at different aspects of disease: iloprost for treating vasculopathy, rituximab (RTX) for blocking B cells, and mycophenolate mofetil (MMF) for inhibiting T cells.Until recently, the gold … Address correspondence to Dr. D. Rimar, Rheumatology Unit, Bnai Zion Medical Center, POB 4940, Haifa, 31048 Israel. Email: doronrimar{at}gmail.com. ER -