Improvement of refractory rheumatoid arthritis-associated constrictive bronchiolitis with etanercept

Cortot, A.; Cottin, Vincent; Miossec, Pierre; Fauchon, Eric; Thivolet‐Béjui, F.; Cordier, Jean-François

doi:10.1016/j.rmed.2004.09.001

Cited by 37 publications

(21 citation statements)

References 9 publications

(10 reference statements)

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“…Treatment with bronchodilators and oral corticosteroids was ineffective in most (84%) of the patients, as previously described [3]. Some improvement was obtained in two patients who received off-label anti-TNF-a regimen for OB (one of these has been previously reported [10]). Lung function further deteriorated in half of the patients, despite therapy, with chronic respiratory failure in 40%, and death in 16%.…”

Section: Discussionmentioning

confidence: 65%

“…Improvement of pulmonary symptoms was obtained in only four patients, three of whom received corticosteroids and two received anti-TNF-a regimens. Pulmonary function tests improved in one patient treated with etanercept [10], with stabilisation in another patient. However, imaging and pulmonary function parameters were not significantly modified by treatment in the remaining patients.…”

Section: Bronchiolitis and Rheumatoid Arthritis G Devouassoux Et Almentioning

confidence: 91%

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Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Devouassoux

Cottin²,

Lioté³

et al. 2009

European Respiratory Journal

108

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The characteristics of patients with rheumatoid arthritis (RA) who develop obliterative bronchiolitis characterised by severe airflow obstruction have been hitherto poorly investigated.A retrospective study of 25 patients with RA and functional evidence of obliterative bronchiolitis (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ,50% and/or residual volume (RV)/total lung capacity (TLC) .140% predicted) was conducted.Patients (mean¡SD age 64¡11 yrs) included 17 never-smokers and eight ex-smokers (10.5¡5.4 pack-yrs). The diagnosis of RA preceded respiratory symptoms in 88% of cases. Dyspnoea on exertion was present in all patients and bronchorrhea in 44%. High-resolution computed tomography findings included: bronchial wall thickening (96%), bronchiectasis (40%), mosaic pattern (40%), centrilobular emphysema (56%), and reticular and/or ground-glass opacities (32%). Pulmonary function tests showed: FEV1 41¡12% pred, FEV1/FVC 49¡14%, FVC 70¡20% pred, RV 148¡68% pred and RV/TLC 142¡34% pred. Lung biopsy, available in nine patients, demonstrated constrictive, follicular and mixed bronchiolitis. Patients were followed for 48.2¡49 months. Treatment was poorly effective. Chronic respiratory failure occurred in 40% of patients, and four patients died.Obliterative bronchiolitis associated with rheumatoid arthritis is a severe and under-recognised condition leading to respiratory failure and death in a high proportion of patients.

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Section: Discussionmentioning

confidence: 65%

Section: Bronchiolitis and Rheumatoid Arthritis G Devouassoux Et Almentioning

confidence: 91%

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Devouassoux

Cottin²,

Lioté³

et al. 2009

European Respiratory Journal

108

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“…Azathioprine and cyclophosphamide have been used, although it is unclear whether these agents have any efficacy [68,69]. A few case reports have described some improvement with anti-TNF therapy [70]. Macrolide antibiotics, in particular erythromycin, may also be effective [65,68].…”

Section: Lower Airway Involvementmentioning

confidence: 99%

Rheumatoid arthritis-associated lung disease

et al. 2015

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“…A trial of systemic steroids may be discussed, but obliterative bronchiolitis usually does not improve with steroids or other immunosuppressive drugs. Case reports suggest that etanercept [84] or low-dose macrolides [41] may show some benefit. In most severe cases, lung transplantation may be proposed [55].…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

Small airways diseases, excluding asthma and COPD: an overview

Burgel¹,

Bergeron²,

Blic³

et al. 2013

European Respiratory Review

104

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This review is the summary of a workshop on small airways disease, which took place in Porquerolles, France in November 2011. The purpose of this workshop was to review the evidence on small airways (bronchiolar) involvement under various pathophysiological circumstances, excluding asthma and chronic obstructive pulmonary disease. Histopathological patterns associated with small airways disease were reviewed, including cellular and obliterative bronchiolitis. Many pathophysiological conditions have been associated with small airways disease including airway infections, connective tissue diseases and inflammatory bowel diseases, bone marrow and lung transplantation, common variable immunodeficiency disorders, diffuse panbronchiolitis, and diseases related to environmental exposures to pollutants, allergens and drugs. Pathogenesis, clinical presentation, a computed tomography scan and pulmonary function test findings are reviewed, and therapeutic options are described with the objective of providing an integrative approach to these disorders.

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Improvement of refractory rheumatoid arthritis-associated constrictive bronchiolitis with etanercept

Cited by 37 publications

References 9 publications

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Rheumatoid arthritis-associated lung disease

Small airways diseases, excluding asthma and COPD: an overview

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