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Rituximab treatment for systemic sclerosis associated interstitial lung disease - A case series of 13 patients.

AIMS
To determine whether rituximab stabilised or improved pulmonary function at 12 months, in patients with systemic sclerosis (SSc) associated interstitial lung disease (ILD).


METHODS
Retrospective analysis was performed at two tertiary centres, of patients with SSc-ILD, who progressed despite conventional therapy and received rituximab between 2008 and 2019. Baseline % forced vital capacity (FVC) and % diffusing capacity of carbon monoxide (DLCO) were compared to 1 year post the first dose of rituximab. Mean and median change in FVC(%) and DLCO(%) were calculated. For those with available data the FVC(%) and DLCO(%) 2 years and 1 year prior to rituximab were compared to the change 12 months post rituximab.


RESULTS
Thirteen patients were included in the analysis. The baseline characteristics were representative of those with SSc-ILD. All patients demonstrated stability in their pulmonary function testing at 1 year post rituximab. The mean FVC(%) was 57.18 (±16.93 SD) prior to rituximab and 59.75 (±18.83 SD) 12 months post rituximab, demonstrating an increase of 2.57 (±4.70 SD) (p-value 0.07). The mean DLCO(%) increased from 37.10 (±18.41 SD) prior to rituximab to 38.03 (± 19.83) post rituximab. The mean change in DLCO(%) was 0.93 (±5.05 SD) (p value 0.53). In the two years preceding rituximab the mean FVC(%) and DLCO(%) declined by 9.25 and 9.66 respectively.


CONCLUSION
This case series suggests that rituximab may stabilise PFTs, and delay deterioration, in patients with progressive SSc-ILD. These findings add to the growing body of evidence suggesting a role for rituximab in the treatment of SSc-ILD. This article is protected by copyright. All rights reserved.