Effective treatment of rheumatoid arthritis-associated interstitial lung disease by B-cell targeted therapy with rituximab.
Rheumatoid arthritis- (RA-) associated interstitial lung disease (RA-ILD) is the extra-articular complication with most adverse impact on the quality of life and survival in RA patients. However, treatment options are limited and controlled studies are lacking. Here, we present the case of a 66-year-old patient suffering from severe RA-ILD, which has been successfully treated with Rituximab (RTX). After failure of conventional DMARD therapy, our patient showed sustained improvement of clinical pulmonary parameters as well as joint inflammation following B-cell depletion with RTX. The six-minute-walk test improved from 380 meters to 536 meters and the forced vital capacity from 2.49 liters to 3.49. The disease activity score could be reduced from 7.7 to 2.8. Therefore, RTX might be considered as an alternative treatment for RA-ILD in patients not responding to conventional DMARD therapy.
Department of Rheumatology and Clinical Immunology, Asklepios Clinic, 93077 Bad Abbach, Germany.
Wolfgang
W
Hartung
Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany.
Judith
J
Maier
Department of Pulmonology and Internal Medicine II, University of Regensburg, 93042 Regensburg, Germany.
Michael
M
Pfeifer
Department of Rheumatology and Clinical Immunology, Asklepios Clinic, 93077 Bad Abbach, Germany ; Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany.
Martin
M
Fleck