Experience Using Rituximab in the Management of Pulmonary Complications of Connective Tissue Disease in a Tertiary Center

Abstract

Pulmonary complications of connective tissue disease (CTD) are common. Recent studies have shown benefit with rituximab (RTX) in the treatment of CTD related interstitial lung disease1,2. We reviewed 5 cases of CTD-ILD receiving RTX. Pre- and post-treatment pulmonary function, exercise physiology, echocardiograph and HRCT thorax data were analysed. Four patients were treated for systemic sclerosis related ILD (SSc- ILD) and one patient had rheumatoid arthritis ILD (RA-ILD). Three patients received RTX after failure of alternate immunosuppression. All 5 patients demonstrated either radiological and/or physiological improvement in response to RTX. No patient had a significant side effect of treatment. RTX is a chimeric monoclonal antibody with activity against CD20 expressed by B-cells. Evidence has shown benefit from rituximab used either alone or in conjunction with otherimmunosuppressive agents.Our patients represent a cohort in whom RTX therapy has been beneficial. These results indicate that consideration should be given toRTXtherapy in patients with connective tissue disease related pulmonary complications. (Figure Presented).