Rituximab Versus Mycophenolate in the Treatment of Recalcitrant Connective Tissue Disease-Associated Interstitial Lung Disease.
ACR Open Rheumatol
; 3(1): 3-7, 2021 Jan.
Article
en En
| MEDLINE
| ID: mdl-33274857
ABSTRACT
OBJECTIVE:
Interstitial lung disease (ILD) is a major cause of morbidity and mortality in connective tissue diseases (CTDs). We aimed to assess the effect of rituximab ± mycophenolate mofetil (MMF) compared with MMF on pulmonary function and prednisone dosage in patients with CTD-related ILD (CTD-ILD).METHODS:
This retrospective study included 83 patients from Stanford and Centre Hospitalier de l'Universite de Montreal. Fifteen patients received rituximab ± MMF (rituximab group), and 68 patients received MMF only (control group).RESULTS:
Median ILD duration at the start of treatment was longer in the rituximab group at 47 months (range 4-170) versus 6.5 months (range 0-164) in controls. Forced vital capacity (FVC) decreased by 3.0% (range 11%-21%) after treatment in the rituximab group, whereas it increased by 2.0% (range 14%-25%) in the control group (p = 0.025). Diffusing capacity of carbon monoxide (DLCO) decreased by 3.0% (range 10%-12%) after treatment in the rituximab group, whereas it increased by 4.5% (range 30%-36%) in the control group (p = 0.046). Mixed model analysis controlling for ILD duration, baseline DLCO, systemic sclerosis, pulmonary hypertension, and prednisone use showed no significant difference in FVC or DLCO between groups at 6 months or 1 year. The average daily prednisone dose score decreased after treatment in the rituximab group, whereas it remained unchanged in the control group (p = 0.017).CONCLUSION:
Rituximab ± MMF did not significantly change pulmonary function compared with MMF alone, but it did result in a relative decrease in average daily prednisone dose in a population with recalcitrant CTD-ILD.
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MEDLINE
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Año:
2021
Tipo del documento:
Article