title: TNF-α antagonist may not be suitable for severe rituximab-induced interstitial lung disease.
abstract: OBJECTIVE
  Rituximab-induced interstitial lung disease (R-ILD) has aroused more concern in recent years. Anti-TNF-α treatment has been suggested for the treatment of severe R-ILD, due to the plausible suggestion that its pathogenesis is related to TNF-α. This commentary aimed to comment on the role of TNF-α antagonists in R-ILD.
  
  
  CONCLUSIONS
  Although most R-ILD patients respond well to glucocorticoids, other treatment options are needed for patients who are refractory to conventional treatment. Contrary to expectations, the TNF-α antagonist etanercept brought no benefit in R-ILD. Moreover, TNF-α-targeted therapies were reported to induce or exacerbate interstitial lung disease.
  
  
  CONCLUSIONS
  The role of TNF-α in the pathogenesis of R-ILD is still unclear due to limited studies on its aetiology. Use of TNF-α antagonists in R-ILD is still speculative, as clinical trials do not support its efficacy. What's more, TNF-α antagonists may themselves induce interstitial lung disease with poor prognosis.
authors: Department of Hematology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors: J
authors: J
authors: Tan
authors: X
authors: X
authors: Ni
mesh_terms: D000818:Animals; D000068800:Etanercept / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects; D017563:Lung Diseases, Interstitial / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D000069283:Rituximab / Q000009:adverse effects*; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D005938:Glucocorticoids; D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D000068800:Etanercept
keywords: TNF-α; interstitial lung disease; rituximab