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Effects of rituximab in connective tissue disorders related interstitial lung disease


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17

 

  1. Dept. of Clinical and Experimental Medicine, AOUC, University of Florence, Italy; and Paris Descartes University, Rheumatology A Dept., APHP, Cochin Hospital, Paris, France.
  2. Paris Descartes University, Rheumatology A Department, APHP, Cochin Hospital, Paris, France.
  3. Spedali Civili di Brescia, Service of Rheumatology and Clinical Immunology, University of Brescia, Italy.
  4. Hospital Clinico San Cecilio, Granada, Spain; on behalf of GEAS-SEMI (Grupo Enfermedades Autoinmune Sistémicas)-(Sociedad Española de Medicina Interna).
  5. Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
  6. Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
  7. Hospital Virgen del Rocio, Department of Internal Medicine, Sevilla, Spain; on behalf of GEAS-SEMI (Grupo Enfermedades Autoinmune Sistémicas)-(Sociedad Española de Medicina Interna).
  8. Hospital Can Misses, Autoimmune Disease Unit, Internal Medicine, Ibiza, Spain; on behalf of GEAS-SEMI (Grupo Enfermedades Autoinmune Sistémicas)-(Sociedad Española de Medicina Interna).
  9. Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
  10. Department of Rheumatology, University Hospital Zurich, Switzerland.
  11. Royal Adelaide Hospital, University of Adelaide, Australia.
  12. Department of Rheumatology, University Hospital Zurich, Switzerland.
  13. Vall D’Hebron General Hospital, Autonoma Univeristy of Barcelona, Internal Medicine, Barcelona, Spain; on behalf of GEAS-SEMI (Grupo Enfermedades Autoinmune Sistémicas)-(Sociedad Española de Medicina Interna).
  14. Sapienza University of Rome, Department of Internal Medicine and Medical Specialities, Rome, Italy.
  15. Department of Rheumatology, University Hospital Zurich, Switzerland.
  16. Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
  17. Paris Descartes University, Rheumatology A Department, APHP, Cochin Hospital, Paris, France.

CER9597
2016 Vol.34, N°5 ,Suppl.100
PI 0181, PF 0185
Treatment

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PMID: 27749242 [PubMed]

Received: 22/05/2016
Accepted : 07/09/2016
In Press: 14/10/2016
Published: 14/10/2016

Abstract

OBJECTIVES:
Interstitial lung disease (ILD) is a key prognostic factor in connective tissue disorders (CTDs). The aim of our study was to assess the changes in pulmonary functional tests (PFTs) in various CTDs, including anti-synthetase syndrome (SYN), systemic sclerosis (SSc) and mixed connective tissue disorder (MCTD), following the use of rituximab therapy.
METHODS:
A multicentre retrospective analysis of patients with ILD secondary to SYN (n=15), MCTD (n=6) and SSc (n=23). PFTs were performed at baseline and at 1 and 2 years of follow-up. The primary outcome was the change in forced vital capacity (FVC) at 1 year.
RESULTS:
In the SYN population, median FVC changed from 53.0% (42.0-90.0) at baseline to 51.4% (45.6-85.0) at 1 year and 63.0 (50-88) (p=0.6) at 2 years (p=0.14). In SSc, FVC changed from 81.0% (66.0-104.0) at baseline to 89.0% (65.0-113.0) at 1 year (p=0.1) and 74.5 (50-91) at 2 years (p=0.07). In the MCTD population, FVC changed from 64.5% (63.0-68.0) at baseline to 63.0% (59.0-71.0) at 1 year (p=0.6) and 61 (59-71) after 2 years (p=0.8). DLCO showed a trend for improvement in the SYN population (p=0.06 at 1 year and 0.2 at years) while changes remain non-significant in the SSc and MCTD patients. In SYN patients, the percentage of responders at 1 year for FVC (33.3%) was greater than in SSc (9.5%) (p=0.07) and MCTD (17%) (p=0.45). RTX showed a satisfactory safety profile.
CONCLUSIONS:
A trend of improvement of PFTs was observed in SYN patients although not reaching significance, while SSc and MCTD patients were stabilised.

Rheumatology Article