title: Rituximab therapy for refractory interstitial lung disease related to antisynthetase syndrome.
abstract: OBJECTIVE
  To report our experience using rituximab as therapy for refractory antisynthetase syndrome (ASS)-associated interstitial lung disease.
  
  
  METHODS
  We retrospectively evaluated the medical records of 7 ASS patients with refractory interstitial lung disease, which had previously failed to respond to prednisone and/or other cytotoxic drugs. All 7 patients received rituximab therapy, i.e.: 1 g at days 0 and 14 and at 6-month follow-up. Data on pulmonary symptoms, pulmonary function tests and high resolution computed tomography (HRCT) scan of the lungs were collected: (1) before rituximab initiation; and (2) at 6-month and one-year follow-up after the first infusion of rituximab.
  
  
  RESULTS
  At one-year follow-up, ASS patients had resolution (n = 2) or improvement of pulmonary clinical manifestations. Patients also exhibited significant improvement of interstitial lung disease parameters: 1) on pulmonary function tests: FVC (p = 0.03) and DLCO (p = 2 × 10(-5)); 2) and HRCT-scan of the lungs. Due to clinical resolution/improvement of interstitial lung disease, the median daily dose of oral prednisone could be reduced in these 7 ASS patients at one-year follow-up, compared with baseline (20 mg/day vs. 9 mg/day; p = 0.015).
  
  
  CONCLUSIONS
  Our findings suggest that rituximab may be a helpful therapy for refractory interstitial lung disease in patients with ASS.
authors.affiliation: Department of Internal medicine, CHU Rouen, 1 rue de Germont, 76031 Rouen Cedex, France. isabelle.marie@chu-rouen.fr
authors.forename: I
authors.initials: I
authors.lastname: Marie
authors.forename: S
authors.initials: S
authors.lastname: Dominique
authors.forename: A
authors.initials: A
authors.lastname: Janvresse
authors.forename: H
authors.initials: H
authors.lastname: Levesque
authors.forename: J-F
authors.initials: JF
authors.lastname: Menard
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood; D016175:B-Lymphocyte Subsets / Q000187:drug effects; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006643:Histidine-tRNA Ligase / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D008212:Lymphocyte Depletion / Q000379:methods; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects; D018482:Muscle, Skeletal / Q000503:physiopathology; D009220:Myositis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies; D000069283:Rituximab; D014057:Tomography, X-Ray Computed / Q000379:methods; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D015415:Biomarkers; D005938:Glucocorticoids; D007155:Immunologic Factors; D000069283:Rituximab; D003402:Creatine Kinase; D006643:Histidine-tRNA Ligase