title: Efficacy and Safety of Rituximab in Connective Tissue Disease related Interstitial Lung Disease.
abstract: BACKGROUND
  Pulmonary complications of connective tissue disease are being identified more frequently with the advent of more sophisticated radiological investigations. Limited previous studies have suggested Rituximab (RTX), a chimeric monoclonal antibody with activity against CD-20, may benefit connective tissue disease patients with pulmonary complications. We performed a retrospective analysis of the efficacy and safety of RTX in patients attending a tertiary referral centre.
  
  
  METHODS
  Ten patients treated with RTX for pulmonary complications of CTD in our institution were identified. Baseline demographics, pre- and post-treatment investigations and adverse events were documented with an average follow up time-frame of 12.3 months (range: 3 - 27). Statistical analysis was performed using the Wilcoxan Signed-Rank test in SPSS.
  
  
  RESULTS
  There was a statistically significant improvement in pulmonary function, with a mean increase of 19% in DLCO (median DLCO (ml/min/mmHg) pre-treatment vs. post-treatment: 13.94 vs. 19.34, p=0.028) and a mean increase of 13% in FVC (median FVC (L) pre-treatment vs. post-treatment: 3.47 vs.3.6, p=0.28). For patients with pulmonary fibrosis (n=7), CT severity was improved on post-treatment scan, though this did not reach statistical significance. There was a reduction in the number of nodules seen on the follow-up scans of two patients without fibrosis. No patient had a severe adverse reaction to RTX.
  
  
  CONCLUSIONS
  Treatment with RTX resulted in an objective, measurable improvement in pulmonary function and/or radiological severity for the majority of patients included in the series. This was statistically significant despite the small numbers included. These results indicate a positive response to RTX with few complications of treatment.
authors.affiliation: Cork University Hospital. deefitzgerald@gmail.com.
authors.forename: Deirdre Brigid
authors.initials: DB
authors.lastname: Fitzgerald
authors.forename: Fiachra
authors.initials: F
authors.lastname: Moloney
authors.forename: Maria
authors.initials: M
authors.lastname: Twomey
authors.forename: John Oisin
authors.initials: JO
authors.lastname: O'Connell
authors.forename: Owen
authors.initials: O
authors.lastname: Cronin
authors.forename: Len
authors.initials: L
authors.lastname: Harty
authors.forename: Sinead
authors.initials: S
authors.lastname: Harney
authors.forename: Michael T
authors.initials: MT
authors.lastname: Henry
mesh_terms: D000328:Adult; D000368:Aged; D003240:Connective Tissue Diseases / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D007494:Ireland; D008168:Lung / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity; D020127:Recovery of Function; D012189:Retrospective Studies; D000069283:Rituximab / Q000009:adverse effects / Q000627:therapeutic use*; D062606:Tertiary Care Centers; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab