Long-term experience with rituximab in anti-synthetase syndrome-related interstitial lung disease

被引：178

作者：

Andersson, Helena ^{[1
,2
]}

Sem, Marthe ^{[2
]}

Lund, May Brit ^{[3
]}

Aalokken, Trond Mogens ^{[4
]}

Gunther, Anne ^{[4
]}

Walle-Hansen, Ragnhild ^{[5
]}

Garen, Torhild ^{[2
]}

Molberg, Oyvind ^{[1
,2
]}

机构：

[1] Oslo Univ Hosp, Inst Clin Med, N-0424 Oslo, Norway

[2] Oslo Univ Hosp, Dept Rheumatol, N-0424 Oslo, Norway

[3] Oslo Univ Hosp, Dept Resp Med, N-0424 Oslo, Norway

[4] Oslo Univ Hosp, Dept Radiol, N-0424 Oslo, Norway

[5] Oslo Univ Hosp, Dept Orthopaed Surg, Oslo, Norway

来源：

RHEUMATOLOGY | 2015年 / 54卷 / 08期

关键词：

rituximab; anti-synthetase syndrome; myositis; anti-aminoacyl tRNA synthetase; anti-Jo1; interstitial lung disease; IDIOPATHIC INFLAMMATORY MYOPATHIES; RESOLUTION COMPUTED-TOMOGRAPHY; JUVENILE DERMATOMYOSITIS; PULMONARY-FIBROSIS; REFRACTORY ADULT; POLYMYOSITIS; THERAPY; AUTOANTIBODIES; PNEUMONIA; SURVIVAL;

D O I：

10.1093/rheumatology/kev004

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objective. To retrospectively evaluate the efficacy and safety of rituximab (Rtx) treatment in patients with anti-synthetase syndrome (ASS) and severe interstitial lung disease (ILD). Methods. Patients with severe ILD and > 12 months follow-up post-Rtx were identified from the Oslo University Hospital ASS cohort (n = 112). Clinical data, including pulmonary function tests (PFTs), were retrospectively collected from medical reports. Extent of ILD pre-, and post-Rtx was scored on thin-section high-resolution CT (HRCT) images and expressed as a percentage of total lung volume. Muscle strength was evaluated by manual muscle testing of eight muscle groups (MMT8). Results. Altogether, 34/112 ASS patients had received Rtx; 24/34 had severe ILD and > 12 months follow-up post-Rtx (median 52 months). In these 24 patients, the median percentage of predicted forced vital capacity, forced expiratory volume in 1 s (FEV1) and diffusing capacity of the lungs for carbon monoxide (DLCO) increased by 24%, 22% and 17%, respectively, post-Rtx. Seven patients (all with disease duration < 12 months and/or acute onset/exacerbation of ILD) had > 30% improvement in all three PFTs. HRCT analysis showed a median 34% reduction in ILD extent post-Rtx. MMT8 score increased post-Rtx. During follow-up, 7/34 (21%) Rtx-treated ASS patients died; 6/7 deaths were related to infections. The mortality rate in the Rtx-treated group was comparable to that of the remaining ASS cohort (25/78 deceased; 32%). Conclusion. This study, which included 24 Rtx-treated ASS patients with severe ILD, reports improved PFTs after a median 52 months follow-up post-Rtx. The best outcome was observed in patients with a disease duration < 12 months and/or acute onset/exacerbation of ILD. The study indicates that Rtx could be a treatment option for selected ASS patients, but infections should be given attention. Key words: rituximab, anti-synthetase syndrome, myositis, anti-aminoacyl tRNA

引用

页码：1420 / 1428

页数：9

共 34 条

[1]

Chest Abnormalities in Juvenile-Onset Mixed Connective Tissue Disease: Assessment with High-Resolution Computed Tomography and Pulmonary Function Tests [J].