Cargando…

Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion

Autoimmune rheumatic diseases may affect vital organs with lung involvement being severe and difficult to treat manifestation. Systemic sclerosis (SSc) commonly affects the lung in the form of interstitial lung disease (ILD). ILD may be also seen in patients with rheumatoid arthritis (RA), Sjögren&#...

Descripción completa

Detalles Bibliográficos
Autores principales: Liossis, Stamatis-Nick C., Bounia, Constantina A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279739/
https://www.ncbi.nlm.nih.gov/pubmed/35847798
http://dx.doi.org/10.3389/fmed.2022.937561
_version_ 1784746466813673472
author Liossis, Stamatis-Nick C.
Bounia, Constantina A.
author_facet Liossis, Stamatis-Nick C.
Bounia, Constantina A.
author_sort Liossis, Stamatis-Nick C.
collection PubMed
description Autoimmune rheumatic diseases may affect vital organs with lung involvement being severe and difficult to treat manifestation. Systemic sclerosis (SSc) commonly affects the lung in the form of interstitial lung disease (ILD). ILD may be also seen in patients with rheumatoid arthritis (RA), Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), inflammatory myositis (IM), antisynthetase syndrome (AS), and the ANCA-associated vasculitides (AAV). Rituximab (RTX) is an anti-CD20 B lymphocyte depleting mAb, often administered in the treatment of autoimmune rheumatic diseases. Although RTX is an off-label treatment for CTD–ILD, there are numerous reports providing data that is effective in improving both pulmonary function tests (PFTs) and chest computed tomography findings consistent with ILD. There are retrospective uncontrolled studies that assess RTX as a treatment of ILD in autoimmune diseases. These studies, apart from one, do not include patients with AAV-ILD. In SSc-ILD, in particular, there are both controlled and uncontrolled studies displaying encouraging results following B cell depletion. In addition, a number of retrospective uncontrolled studies and fewer prospective studies evaluate RTX in connective tissue diseases CTD–ILD. Although RTX is an approved treatment for AAV there are scarce only data focusing on patients with AAV-ILD specifically. The results of a handful of studies comparing treatment of CTD-ILD with RTX to treatment with other agents are in favor of RTX. Results from large, still ongoing controlled trials are awaited to ascertain RTX effects in ILD encountered in autoimmune rheumatic diseases. We review herein the results of the different RTX trials in patients with autoimmune disease–associated with ILD. Despite the heterogeneity of these studies, RTX may be considered an alternative and safe but still off-label treatment for patients with refractory CTD–ILD.
format Online
Article
Text
id pubmed-9279739
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-92797392022-07-15 Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion Liossis, Stamatis-Nick C. Bounia, Constantina A. Front Med (Lausanne) Medicine Autoimmune rheumatic diseases may affect vital organs with lung involvement being severe and difficult to treat manifestation. Systemic sclerosis (SSc) commonly affects the lung in the form of interstitial lung disease (ILD). ILD may be also seen in patients with rheumatoid arthritis (RA), Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), inflammatory myositis (IM), antisynthetase syndrome (AS), and the ANCA-associated vasculitides (AAV). Rituximab (RTX) is an anti-CD20 B lymphocyte depleting mAb, often administered in the treatment of autoimmune rheumatic diseases. Although RTX is an off-label treatment for CTD–ILD, there are numerous reports providing data that is effective in improving both pulmonary function tests (PFTs) and chest computed tomography findings consistent with ILD. There are retrospective uncontrolled studies that assess RTX as a treatment of ILD in autoimmune diseases. These studies, apart from one, do not include patients with AAV-ILD. In SSc-ILD, in particular, there are both controlled and uncontrolled studies displaying encouraging results following B cell depletion. In addition, a number of retrospective uncontrolled studies and fewer prospective studies evaluate RTX in connective tissue diseases CTD–ILD. Although RTX is an approved treatment for AAV there are scarce only data focusing on patients with AAV-ILD specifically. The results of a handful of studies comparing treatment of CTD-ILD with RTX to treatment with other agents are in favor of RTX. Results from large, still ongoing controlled trials are awaited to ascertain RTX effects in ILD encountered in autoimmune rheumatic diseases. We review herein the results of the different RTX trials in patients with autoimmune disease–associated with ILD. Despite the heterogeneity of these studies, RTX may be considered an alternative and safe but still off-label treatment for patients with refractory CTD–ILD. Frontiers Media S.A. 2022-06-30 /pmc/articles/PMC9279739/ /pubmed/35847798 http://dx.doi.org/10.3389/fmed.2022.937561 Text en Copyright © 2022 Liossis and Bounia. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Liossis, Stamatis-Nick C.
Bounia, Constantina A.
Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion
title Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion
title_full Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion
title_fullStr Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion
title_full_unstemmed Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion
title_short Treating Autoimmune-Related Interstitial Lung Disease With B Cell Depletion
title_sort treating autoimmune-related interstitial lung disease with b cell depletion
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279739/
https://www.ncbi.nlm.nih.gov/pubmed/35847798
http://dx.doi.org/10.3389/fmed.2022.937561
work_keys_str_mv AT liossisstamatisnickc treatingautoimmunerelatedinterstitiallungdiseasewithbcelldepletion
AT bouniaconstantinaa treatingautoimmunerelatedinterstitiallungdiseasewithbcelldepletion