scholarly journals Effective Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease by B-Cell Targeted Therapy with Rituximab

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Wolfgang Hartung ◽  
Judith Maier ◽  
Michael Pfeifer ◽  
Martin Fleck
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
B Cell ◽  
Treatment Options ◽  
Joint Inflammation ◽  
Dmard Therapy ◽  
Sustained Improvement ◽  
Minute Walk

Rheumatoid arthritis- (RA-) associated interstitial lung disease (RA-ILD) is the extra-articular complication with most adverse impact on the quality of life and survival in RA patients. However, treatment options are limited and controlled studies are lacking. Here, we present the case of a 66-year-old patient suffering from severe RA-ILD, which has been successfully treated with Rituximab (RTX). After failure of conventional DMARD therapy, our patient showed sustained improvement of clinical pulmonary parameters as well as joint inflammation following B-cell depletion with RTX. The six-minute-walk test improved from 380 meters to 536 meters and the forced vital capacity from 2.49 liters to 3.49. The disease activity score could be reduced from 7.7 to 2.8. Therefore, RTX might be considered as an alternative treatment for RA-ILD in patients not responding to conventional DMARD therapy.

scholarly journals Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

2019 ◽  
Vol 8 (12) ◽  
pp. 2038 ◽  
Author(s):  
Elisabeth Bendstrup ◽  
Janne Møller ◽  
Sissel Kronborg-White ◽  
Thomas Skovhus Prior ◽  
Charlotte Hyldgaard
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Treatment Options ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Antifibrotic Therapy ◽  
New Treatment ◽  
Diagnostic Work ◽  
Evidence Based Therapy

Interstitial lung disease (ILD) is a serious complication of rheumatoid arthritis (RA) contributing to significantly increased morbidity and mortality. Other respiratory complications, such as chronic obstructive pulmonary disease and bronchiectasis, are frequent in RA. Infections and drug toxicity are important differential diagnoses and should be considered in the diagnostic work-up of patients with RA presenting with respiratory symptoms. This review provides an overview of the epidemiology and pathogenesis of RA-ILD, the radiological and histopathological characteristics of the disease as well as the current and future treatment options. Currently, there is no available evidence-based therapy for RA-ILD, and immunosuppressants are the mainstay of therapy. Ongoing studies are exploring the role of antifibrotic therapy in patients with progressive fibrotic ILD, which may lead to a new treatment approach for subgroups of patients with RA-ILD.

scholarly journals Ongoing clinical trials and treatment options for patients with systemic sclerosis–associated interstitial lung disease

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 567-579 ◽  
Author(s):  
Dinesh Khanna ◽  
Donald P Tashkin ◽  
Christopher P Denton ◽  
Martin W Lubell ◽  
Cristina Vazquez-Mateo ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Multiple Organ ◽  
Organ Systems ◽  
The Uk ◽  
Disease Modifying Treatment ◽  
Substantial Morbidity

Abstract SSc is a rare CTD that affects multiple organ systems, resulting in substantial morbidity and mortality. Evidence of interstitial lung disease (ILD) is seen in ∼80% of patients with SSc. Currently there is no approved disease-modifying treatment for ILD and few effective treatment options are available. CYC is included in treatment guidelines, but it has limited efficacy and is associated with toxicity. MMF is becoming the most commonly used medication in clinical practice in North America and the UK, but its use is not universal. Newer agents targeting the pathogenic mechanisms underlying SSc-ILD, including fibrotic and inflammatory pathways, lymphocytes, cell–cell and cell–extracellular membrane interactions, hold promise for better treatment outcomes, including improved lung function, patient-related outcomes and quality of life. Here we review ongoing trials of established and novel agents that are currently recruiting patients with SSc-ILD.

Survival and quality of life in rheumatoid arthritis–associated interstitial lung disease after lung transplantation

2014 ◽  
Vol 33 (5) ◽  
pp. 514-520 ◽  
Author(s):  
Arash Yazdani ◽  
Lianne G. Singer ◽  
Vibeke Strand ◽  
Allan C. Gelber ◽  
Laura Williams ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Transplantation ◽  
Lung Disease

scholarly journals Understanding the determinants of health-related quality of life in rheumatoid arthritis-associated interstitial lung disease

2017 ◽  
Vol 127 ◽  
pp. 1-6 ◽  
Author(s):  
Jake G. Natalini ◽  
Jeff J. Swigris ◽  
Julie Morisset ◽  
Brett M. Elicker ◽  
Kirk D. Jones ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Determinants Of Health ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Systematic review and meta-analysis of the risk of rheumatoid arthritis-associated interstitial lung disease related to anti-cyclic citrullinated peptide (CCP) antibody

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040465
Author(s):  
Hiroyuki Kamiya ◽  
Ogee Mer Panlaqui
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Quality Of Evidence ◽  
Cyclic Citrullinated Peptide ◽  
The Mean ◽  
Citrullinated Peptide

ObjectiveTo clarify the risk of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) related to anti-cyclic citrullinated peptide (CCP) antibody.Eligibility criteriaPatients with RA with and without ILD were eligible. The primary outcome was the prevalence or incidence of ILD. Primary studies of any design aside from a case report were eligible.Information sourcesMedline, EMBASE, Science Citation Index Expanded and Cochrane Central Register of Controlled Trials were searched from the inception through 12 November 2019.Data extraction and risk of biasTwo reviewers independently selected eligible reports, extracted relevant data and assessed risk of bias using a modified Quality in Prognostic Studies tool.Data synthesisMeta-analysis was conducted using a random-effects model.Quality of evidenceThe Grades of Recommendation, Assessment, Development and Evaluation system was applied.ResultsAmong 29 out of 827 records retrieved through electronic databases and four additional reports identified from other sources, 29 studies were focused for the review. A total of 10158 subjects were included and the mean age at inclusion was between 45.8 and 63.9 years. The mean RA duration was between 4.3 and 14.9 years. The positivity of anti-CCP antibody ranged from 50.7% to 95.8%. All studies except for two were deemed as high risk of bias. A pooled analysis of univariate results demonstrated that the presence of anti-CCP antibody was significantly associated with RA-ILD with an OR of 2.10 (95% CI: 1.59 to 2.78). Similarly, the titre of anti-CCP antibody was significantly higher for RA-ILD with a standardised mean difference of 0.42 (95% CI: 0.20 to 0.65). These results were confirmed by multivariate analysis in the majority of studies and consistent by any subgroup and sensitivity analyses.ConclusionThe presence and higher titres of anti-CCP antibody were suggested to be significantly associated with an increased risk of RA-ILD. However, the quality of evidence was rated as low or very low.

scholarly journals Treatment with Etanercept in a Patient with Rheumatoid Arthritis-Associated Interstitial Lung Disease

2011 ◽  
Vol 4 ◽  
pp. CCRep.S8150 ◽  
Author(s):  
Yu Wang ◽  
Sheng-qian Xu ◽  
Jian-hua Xu ◽  
Changhai Ding
Keyword(s):  
Rheumatoid Arthritis ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Respiratory Function ◽  
Marked Improvement ◽  
Sustained Improvement ◽  
Function Test ◽  
Lower Lung ◽  
History Of

We report a case of a 52-year-old woman with a 1-year history of rheumatoid arthritis-associated interstitial lung disease referred to hospital because of aggravated pulmonary symptoms in spite of intensive treatment including prednisone, azathioprine and triptergium glycoside. We subsequently initiated treatment with 25 mg of etanercept, subcutaneously injected twice weekly. Following 6 months of therapy with this agent, sustained improvement in dyspnea, cough was reported by the patient and respiratory function test showed marked improvement. The improvement was confirmed by reduced middle and lower lung markings on chest radiography and high-resolution CT scan. This report suggests etanercept may be effective in the treatment of rheumatoid arthritis-associated interstitial lung disease.

scholarly journals Rheumatoid Arthritis-Associated Interstitial Lung Disease: Diagnostic Dilemma

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Mark J. Hamblin ◽  
Maureen R. Horton
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Drug Toxicity ◽  
Treatment Options ◽  
Experimental Treatment ◽  
Environmental Toxins ◽  
Diagnostic Dilemma ◽  
Clinical Algorithm

Interstitial lung disease (ILD) is an increasingly recognized complication of rheumatoid arthritis (RA) contributing to significantly increased morbidity and mortality. Diagnosis can be challenging since patients are unlikely to report dyspnea due to an overall decrease in physical activity with advanced arthritic symptoms. Additionally, infections, drug toxicity, and environmental toxins can mimic ILD, creating significant diagnostic dilemmas for the clinician. In this paper we will explore an effective clinical algorithm for the diagnosis of RA-ILD. We will also discuss features of drug-related toxicities, infections, and environmental toxins that comprise the main entities in the differential diagnosis of RA-ILD. Finally, we will explore the known and experimental treatment options that may have some benefit in the treatment of RA-ILD.

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