Rituximab treatment of the anti-synthetase syndrome: a retrospective case series.
OBJECTIVE
Interstitial lung disease (ILD) is the major determinant of morbidity and mortality in the anti-synthetase syndrome (ASS). Here we have retrospectively assessed 11 ASS patients with ILD treated with the anti-CD20 mAB rituximab at our tertiary referral hospital.


METHODS
Data on clinical and laboratory parameters, lung imaging by high-resolution CT thorax and pulmonary function tests were collected from patient examinations done up to 6 months before rituximab was initiated, and at 3 and 6 months post-treatment.


RESULTS
All the 11 ASS patients had severe and progressive ILD and most of them had previously failed on cyclophosphamide and/or other immuno-modulating agents. Rituximab appeared to stabilize and/or improve the ILD in 7 of 11 ASS patients during the first 6 months after treatment. The rituximab treatment appeared to decrease the serum level of anti-Jo-1 antibodies, but the decrease was most often modest. One patient developed a fatal infection 3 months after the last infusion with rituximab. In the other ASS patients, the treatment was well tolerated.


CONCLUSIONS
This retrospective case series indicates a short-term beneficial effect of rituximab in ASS. Prospective, controlled studies are needed to validate this finding and further assess safety issues.
Sem
Marthe
M
Department of Rheumatology, Rikshospitalet University Hospital, Oslo, Norway.
Molberg
Oyvind
O
Lund
May Brit
MB
Gran
Jan Tore
JT
D000974:Antibodies, Antinuclear / Q000276:immunology*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017285:Polymyositis / Q000188:drug therapy*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D000069283:Rituximab; D013577:Syndrome; D016896:Treatment Outcome
D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; C046750:Jo-1 antibody; D000069283:Rituximab; D003402:Creatine Kinase