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Rituximab improves interstitial lung disease associated with antisynthetase syndrome

10 Jun 2018

Treatment with rituximab (RTX) is well tolerated and leads to stability or improvement in pulmonary function or severity of interstitial lung disease (ILD) on computed tomography (CT) in most patients, a recent study has shown.

A total of 25 patients at the Brigham and Women’s Hospital (n=13) and University of Pittsburgh Medical Center (n=12) participated in the study. Antisynthetase antibodies (16 Jo1, six PL-12 and three PL-7) were identified in all patients. The main indication for RTX use in 21 patients (84 percent) was recurrent or progressive ILD due to the failure of other agents.

Comparisons between pre- and post-RTX pulmonary variables at 12 months showed stable or improved CT score and forced vital capacity in 88 percent and 79 percent of patients, respectively. Total lung capacity (%) increased from 56±13 to 64±13, and glucocorticoid dose decreased from 18±9 to 12±12 mg/day. Diffusing capacity of the lungs for carbon monoxide slightly decreased at 1 year, but it increased from 42±17 to 70±20 at 3 years.

Nonspecific interstitial pneumonia (NSIP; n=13) and usual interstitial pneumonia/fibrotic NSIP (n=5) were the most common imaging patterns on CT. Of these, five had concurrent elements of cryptogenic organizing pneumonia.

“RTX may play a therapeutic role in patients with antisynthetase syndrome (AS)-ILD, and further clinical investigation is warranted,” the authors said.

To evaluate clinical outcomes in patients with AS-ILD, the authors retrospectively identified all patients at two institutions who were treated with RTX and assessed baseline demographics, pulmonary function testing and chest CT pre- and post-RTX. Two radiologists independently evaluated CT using a standardized scoring system.

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Most Read Articles
Stephen Padilla, 21 hours ago
Treatment with oral thrombopoietin receptor agonist eltrombopag leads to similar platelet counts in patients with chronic immune thrombocytopaenia (cITP) and persistent (per)ITP, according to the results of phase III (EXTEND) and IV studies presented at the 23rd Congress of the European Hematology Association (EHA 2018) held in Stockholm, Sweden.
Pearl Toh, 3 days ago
Lonely people were twice as likely to die from any cause than people who did not feel lonely, according to a study based on a national survey presented at the recent EuroHeartCare 2018 in Dublin, Ireland. Also, loneliness is associated with poorer patient-reported outcomes in terms of mental and physical health in patients with heart disease.
6 days ago
Higher activity of plasma xanthine oxidase appears to be linked to insulin resistance and liver dysfunction among type 2 diabetes mellitus (T2DM) patients with metabolic syndrome (MetS), according to a recent Japan study.
6 days ago
Use of quetiapine among critically ill patients rarely leads to corrected QT (QTc) interval prolongation, reports a new study.