Treatment
Effects of rituximab in connective tissue disorders related interstitial lung disease
G. Lepri1, J. Avouac2, P. Airò3, F. Anguita Santos4, S. Bellando-Randone5, J. Blagojevic6, F. Garcia Hernàndez7, J.A. Gonzalez Nieto8, S. Guiducci9, S. Jordan10, V. Limaye11, B. Maurer12, A. Selva-O'callaghan13, V. Riccieri14, O. Distler15, M. Matucci-Cerinic16, Y. Allanore17
- Dept. of Clinical and Experimental Medicine, AOUC, University of Florence, Italy; and Paris Descartes University, Rheumatology A Dept., APHP, Cochin Hospital, Paris, France.
- Paris Descartes University, Rheumatology A Department, APHP, Cochin Hospital, Paris, France.
- Spedali Civili di Brescia, Service of Rheumatology and Clinical Immunology, University of Brescia, Italy.
- Hospital Clinico San Cecilio, Granada, Spain; on behalf of GEAS-SEMI (Grupo Enfermedades Autoinmune Sistémicas)-(Sociedad Española de Medicina Interna).
- Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
- Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
- Hospital Virgen del Rocio, Department of Internal Medicine, Sevilla, Spain; on behalf of GEAS-SEMI (Grupo Enfermedades Autoinmune Sistémicas)-(Sociedad Española de Medicina Interna).
- Hospital Can Misses, Autoimmune Disease Unit, Internal Medicine, Ibiza, Spain; on behalf of GEAS-SEMI (Grupo Enfermedades Autoinmune Sistémicas)-(Sociedad Española de Medicina Interna).
- Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
- Department of Rheumatology, University Hospital Zurich, Switzerland.
- Royal Adelaide Hospital, University of Adelaide, Australia.
- Department of Rheumatology, University Hospital Zurich, Switzerland.
- 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).
- Sapienza University of Rome, Department of Internal Medicine and Medical Specialities, Rome, Italy.
- Department of Rheumatology, University Hospital Zurich, Switzerland.
- Department of Clinical and Experimental Medicine, AOUC, University of Florence, Italy.
- 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.