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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/214883
Rituximab in the treatment of progressive interstitial lung disease associated with the antisynthetase syndrome
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Objective To assess the real-world, long-term effectiveness of rituximab (RTX) as a rescue therapy in patients with antisynthetase syndrome and progressive interstitial lung disease (ASS-ILD). Methods Multicentre observational retrospective longitudinal study of a cohort of patients with ASS-ILD that started treatment with RTX due to recurrent or ongoing progressive ILD despite therapy with glucocorticoids and immunosuppressants. Results Twenty-eight patients were analyzed. Examining the entire study population, before treatment with RTX the mean decline in %pFVC and %pDLCO from the ASS-ILD diagnosis to the initiation of RTX treatment (T0) was -6.44% and -14.85%, respectively. After six months of treatment, RTX reversed the decline in pulmonary function test (PFT) parameters: triangle%pFVC +6.29% (95% CI: -10.07 to 2.51; p=0.002 compared to T0) and triangle%pDLCO +6.15% (95% CI: -10.86 to -1.43; p=0.013). Twenty-four patients completed one year of therapy and 22 two years, maintaining the response in PFT: triangle%pFVC: +9.93% (95% CI: -15.61 to -4.25; p=0.002) and triangle%pDLCO: +7.66% (95% CI: -11.67 to -3.65; p<0.001). In addition, there was a significant reduction in the median dose of prednisone, and it could be suspended in 18% of cases. In 33% of patients who required oxygen therapy at the start of treatment, it could be discontinued. The frequency of adverse events reached 28.5% of cases. Results Twenty-eight patients were analyzed. Examining the entire study population, before treatment with RTX the mean decline in %pFVC and %pDLCO from the ASS-ILD diagnosis to the initiation of RTX treatment (T0) was -6.44% and -14.85%, respectively. After six months of treatment, RTX reversed the decline in pulmonary function test (PFT) parameters: triangle%pFVC +6.29% (95% CI: -10.07 to 2.51; p=0.002 compared to T0) and triangle%pDLCO +6.15% (95% CI: -10.86 to -1.43; p=0.013). Twenty-four patients completed one year of therapy and 22 two years, maintaining the response in PFT: triangle%pFVC: +9.93% (95% CI: -15.61 to -4.25; p=0.002) and triangle%pDLCO: +7.66% (95% CI: -11.67 to -3.65; p<0.001). In addition, there was a significant reduction in the median dose of prednisone, and it could be suspended in 18% of cases. In 33% of patients who required oxygen therapy at the start of treatment, it could be discontinued. The frequency of adverse events reached 28.5% of cases. Conclusion Based on our results, RTX appears to be effective as rescue therapy in most patients with recurrent or progressive ASS-ILD unresponsive to conventional treatment. The use of RTX was well tolerated in the majority of patients.
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NARVÁEZ, Javier, CAÑADILLAS, Elena, CASTELLVÍ, Ivan, ALEGRE, Juan josé, VINCENS ZYGMUNT, Vanesa, BERMUDO, Guadalupe, VIDAL MONTAL, Paola, MOLINA MOLINA, María, NOLLA SOLÉ, Joan miquel. Rituximab in the treatment of progressive interstitial lung disease associated with the antisynthetase syndrome. _Arthritis Research & Therapy_. 2024. Vol. 26, núm. 1. [consulta: 28 de gener de 2026]. ISSN: 1478-6362. [Disponible a: https://hdl.handle.net/2445/214883]