J Clin Rheumatol. 2017 Dec;23(8):411-415. doi: 10.1097/RHU.0000000000000584.
The objective of this study was to report the experience with rituximab treatment in a case series of patients with long-standing systemic sclerosis-associated interstitial lung disease (SSc-ILD).
We reviewed the charts of 197 SSc patients. Fourteen patients who received rituximab for SSc-ILD participated in this analysis. Pulmonary function tests, high-resolution thorax computed tomography and modified Rodnan skin scores were evaluated at baseline and end of the follow-up.
Median age was 53.2 years (interquartile range, 46.8-55.5 years), and median disease duration was 9.1 years (interquartile range, 5.1-13.6 years). At the end of median follow-up (15 months), although the median forced vital capacity value increased compared with baseline, the change was not statistically significant (52.5 vs. 58.0, P = 0.065). Forced vital capacity was improved in 4 patients and stabilized in 10 patients. High-resolution computed tomography was stable in 7 patients and worsened in 3 patients. Modified Rodnan skin scores remained stable at the end of follow-up (8.0 vs. 6.0, P = 0.6).
The improvement or stabilization of pulmonary disease was observed in most SSc patients with longer disease duration and worse pulmonary function. Rituximab might be useful in this patient group who is resistant to conventional immunosuppressive treatments.
本研究旨在报告利妥昔单抗治疗长期系统性硬皮病相关间质性肺病（SSc-ILD）患者的系列病例经验。
我们回顾了 197 例 SSc 患者的病历。14 例接受利妥昔单抗治疗 SSc-ILD 的患者参与了本次分析。在基线和随访结束时评估了肺功能测试、高分辨率胸部计算机断层扫描和改良 Rodnan 皮肤评分。
中位年龄为 53.2 岁（四分位距，46.8-55.5 岁），中位病程为 9.1 年（四分位距，5.1-13.6 年）。在中位随访时间（15 个月）结束时，虽然用力肺活量值与基线相比有所增加，但差异无统计学意义（52.5 对 58.0，P=0.065）。4 例患者的用力肺活量改善，10 例患者的用力肺活量稳定。7 例患者的高分辨率计算机断层扫描稳定，3 例患者的高分辨率计算机断层扫描恶化。改良 Rodnan 皮肤评分在随访结束时保持稳定（8.0 对 6.0，P=0.6）。
在病程较长且肺功能较差的 SSc 患者中，观察到肺部疾病的改善或稳定。利妥昔单抗可能对常规免疫抑制治疗耐药的这组患者有用。
