The following is a summary of “Rituximab in the treatment of progressive interstitial lung disease associated with the antisynthetase syndrome,” published in the June 2024 issue of Rheumatology by Narváez et al.

This study evaluates the long-term effectiveness of rituximab (RTX) as a rescue therapy for patients with antisynthetase syndrome-associated progressive interstitial lung disease (ASS-ILD) who do not respond to conventional treatments. Conducted as a multicenter observational retrospective longitudinal study, it included patients who began RTX treatment due to recurrent or ongoing progressive ILD despite the use of glucocorticoids and immunosuppressants.

In total, 28 patients were analyzed. Before RTX treatment, the mean decline in percent predicted forced vital capacity (∆%pFVC) and percent predicted diffusing capacity for carbon monoxide (∆%pDLCO) from the time of ASS-ILD diagnosis to the initiation of RTX (T0) was -6.44% and -14.85%, respectively. Six months after starting RTX, pulmonary function test (PFT) parameters showed significant improvement: ∆%pFVC increased by 6.29% (95% CI: -10.07 to 2.51; p=0.002 compared to T0) and ∆%pDLCO increased by 6.15% (95% CI: -10.86 to -1.43; p=0.013).

Of the initial cohort, 24 patients completed one year of therapy, and 22 patients completed two years, maintaining positive PFT responses: ∆%pFVC increased by 9.93% (95% CI: -15.61 to -4.25; p=0.002) and ∆%pDLCO increased by 7.66% (95% CI: -11.67 to -3.65; p<0.001). Additionally, the median prednisone dose was significantly reduced, and in 18% of cases, prednisone was discontinued altogether. Furthermore, 33% of patients who required oxygen therapy at the start of RTX treatment could discontinue its use.

The incidence of adverse events was 28.5%, indicating that RTX was generally well tolerated.

In conclusion, the results suggest that rituximab is an effective rescue therapy for most patients with recurrent or progressive ASS-ILD unresponsive to conventional treatments. The improvements in pulmonary function and the reduction in prednisone use underscore its potential as a valuable treatment option for this patient population.

Source: arthritis-research.biomedcentral.com/articles/10.1186/s13075-024-03353-2