Rituximab in the Treatment of Interstitial Lung Disease Associated with Antisynthetase Syndrome: A Multicenter Retrospective Case Review

Doyle, Tracy J.; Dhillon, Namrata; Madan, Rachna; Cabral, Fernanda Caseira; Fletcher, Elaine; Koontz, Diane; Aggarwal, Rohit; Osorio, Juan C.; Rosas, Iván O.; Oddis, Chester V.; Dellaripa, Paul F.

doi:10.3899/jrheum.170541

Cited by 86 publications

(69 citation statements)

References 47 publications

(57 reference statements)

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“…[90][91][92] In another series of 25 subjects with ARS and ILD, stability or improvement of PFTor imaging was seen in the majority of the patients. 93 Overall, rituximab appears as a drug of choice in the management of refractory IIM-related ILD and of rapidly progressive ILD. Prospective randomized trials are ongoing to assess the efficacy and tolerability of rituximab in the spectrum of CTD-related ILD.…”

Section: Rituximabmentioning

confidence: 99%

Lung Diseases in Inflammatory Myopathies

Barba

Mainbourg

Nasser

et al. 2019

Semin Respir Crit Care Med

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Lung involvement is the leading cause of mortality in inflammatory myopathy. A careful assessment of clinical and serologic manifestations especially myositis-associated autoantibodies allows precise classification of the different phenotypes of inflammatory myopathy and stratification of the risk of lung involvement. About three out of four patients with inflammatory myopathy develop interstitial lung disease (ILD), which represents the main cause of morbidity and mortality. In patients with a confirmed diagnosis of inflammatory myopathy, the approach to the diagnosis of ILD includes assessment of clinical and functional severity, evaluation of the high-resolution computed tomography pattern of disease, which often suggests nonspecific interstitial pneumonia or organizing pneumonia. Bronchoalveolar lavage to rule out infection is often performed; however, video-assisted thoracoscopic lung biopsy is now generally discouraged, unless malignancy is suspected. The so-called antisynthetase syndrome characterized by the combination of mechanics' hands, Raynaud' phenomenon, myositis often mild or absent, and presence of one of the anti-tRNA synthetase antibodies is associated with a 70% risk of ILD, especially in subjects with antibodies other than anti-Jo1 antibodies (i.e., anti-PL7 or -PL12 antibodies). Treatment depends on both severity and progression of ILD, often including a combination of corticosteroids and immunosuppressive therapy. Rituximab-based regimen has showed promising results in retrospective studies for the management of refractory or rapidly progressive forms of ILD. Clinical trials are ongoing to evaluate the actual efficacy of this strategy on mortality related to lung disease. Secondary pulmonary complications of inflammatory myopathy include opportunistic infections, aspiration pneumonia, pneumomediastinum, ventilatory failure due to diaphragmatic muscular weakness, drug-induced pneumonitis, and rarely pulmonary hypertension.

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Section: Rituximabmentioning

confidence: 99%

Lung Diseases in Inflammatory Myopathies

Barba

Mainbourg

Nasser

et al. 2019

Semin Respir Crit Care Med

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“…So far, the highest reported number of patients with antisynthetase syndrome treated with RTX is 33, and the longest median followup is 52 months [12][13][14][15][16][17][18][19][20][21]22,23 . In case reports and series, RTX has been shown to be effective in treating antisynthetase syndrome.…”

Section: Rheumatologymentioning

confidence: 99%

Rituximab in the Treatment of Jo1 Antibody–associated Antisynthetase Syndrome: Anti-Ro52 Positivity as a Marker for Severity and Treatment Response

et al. 2016

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“…84,85 There has been growing enthusiasm for the use of rituximab, a monoclonal antibody against the CD20 B-cell surface marker, in the treatment of this entity. 86…”

Section: Iims and Asmentioning

confidence: 99%

Interstitial Lung Disease and Other Pulmonary Manifestations in Connective Tissue Diseases

Mira-Avendano

Abril

Burger

et al. 2019

Mayo Clinic Proceedings

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Rituximab in the Treatment of Interstitial Lung Disease Associated with Antisynthetase Syndrome: A Multicenter Retrospective Case Review

Abstract: Stability or improvement in pulmonary function or severity of ILD on CT was seen in most patients. Use of RTX was well tolerated in the majority of patients. RTX may play a therapeutic role in patients with AS-ILD, and further clinical investigation is warranted.

Cited by 86 publications

References 47 publications

Lung Diseases in Inflammatory Myopathies

Lung Diseases in Inflammatory Myopathies

Rituximab in the Treatment of Jo1 Antibody–associated Antisynthetase Syndrome: Anti-Ro52 Positivity as a Marker for Severity and Treatment Response

Interstitial Lung Disease and Other Pulmonary Manifestations in Connective Tissue Diseases

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