A single center experience of rituximab for anti synthetase syndrome associated interstitial lung disease (ASS-ILD)

Introduction: The ASS-ILD is often severe and rapidly progressive, causing much of the increased morbidity and mortality of ASS-ILD compared with other connective tissue diseases. Aim: Our aim was to assess whether rituximab (a monoclonal antibody against CD20 in B cells) was effective in very severe ASS-ILD, who were treated with conventional immunosuppression including cyclophosphamide. Methodology: We performed a retrospective analysis of 10 patients with severe ASS-ILD treated with rituximab. Pulmonary functions performed 9-12 months prior to the commencement of rituximab was compared with 9-12 months following treatment. Results: N=5 showed improvement in the Forced Vital Capacity (FVC), while the rest showed stability. N=7 showed stability in the Diffusion Capacity (DLCO) and the rest showed improvement. The median and mean improvement in FVC following rituximab were 11.5% and 9.4% respectively, while median and mean improvement of DLCO were 11.1% and 20% respectively (Figure 1 and 2). Conclusion: In severe ASS-ILD, rituximab may represent an effective therapeutic intervention.