Elsevier

Respiratory Medicine

Volume 106, Issue 4, April 2012, Pages 581-587
Respiratory Medicine

Rituximab therapy for refractory interstitial lung disease related to antisynthetase syndrome

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Summary

Objective

To report our experience using rituximab as therapy for refractory antisynthetase syndrome (ASS)-associated interstitial lung disease.

Methods

We retrospectively evaluated the medical records of 7 ASS patients with refractory interstitial lung disease, which had previously failed to respond to prednisone and/or other cytotoxic drugs. All 7 patients received rituximab therapy, i.e.: 1 g at days 0 and 14 and at 6-month follow-up. Data on pulmonary symptoms, pulmonary function tests and high resolution computed tomography (HRCT) scan of the lungs were collected: 1) before rituximab initiation; and 2) at 6-month and one-year follow-up after the first infusion of rituximab.

Results

At one-year follow-up, ASS patients had resolution (n = 2) or improvement of pulmonary clinical manifestations. Patients also exhibited significant improvement of interstitial lung disease parameters: 1) on pulmonary function tests: FVC (p = 0.03) and DLCO (p = 2 × 10−5); 2) and HRCT-scan of the lungs. Due to clinical resolution/improvement of interstitial lung disease, the median daily dose of oral prednisone could be reduced in these 7 ASS patients at one-year follow-up, compared with baseline (20 mg/day vs. 9 mg/day; p = 0.015).

Conclusion

Our findings suggest that rituximab may be a helpful therapy for refractory interstitial lung disease in patients with ASS.

Keywords

Polymyositis
Dermatomyositis
Antisynthetase syndrome
Interstitial lung disease
Rituximab

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