Effect of rituximab on pulmonary function in patients with rheumatoid arthritis

Franzen, Daniel and Ciurea, Adrian and Bratton, Daniel J. and Clarenbach, Christian F. and Latshang, Tsogyal D. and Russi, Erich W. and Kyburz, Diego and Kohler, Malcolm. (2016) Effect of rituximab on pulmonary function in patients with rheumatoid arthritis. Pulmonary Pharmacology & Therapeutics, 37. pp. 24-29.

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Official URL: https://edoc.unibas.ch/62297/

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BACKGROUND: Rituximab (RTX), a B-cell depleting monoclonal antibody is increasingly used in several antibody-mediated diseases. It has been reported to cause pulmonary toxicity, though mainly during polychemotherapy of malignant lymphoma. Prospective data on RTX-induced pulmonary complications in patients with rheumatoid arthritis (RA) are lacking. METHODS AND METHODS: Serial spirometries and measurements of diffusion capacity of the lung for carbon monoxide (DLCO) in patients with RA before and 2, 4, 8, and 26 weeks after treatment with RTX were performed. A reduction from baseline of forced vital capacity (FVC) of </=10%, or </=15% of DLCO was defined as indicative for pulmonary toxicity. RESULTS: Thirty-three patients (mean (SD) age 59 (12) years, 27% males) were included. Mean (SD) FVC predicted and DLCO predicted at baseline were 108% (18%) and 88% (18%), respectively. In contrast to FVC, DLCO showed a progressive decline during follow-up with a maximum reduction of 6.1% (95%CI 2.5%, 9.7%; p = 0.001) at 26 weeks compared with baseline. After 26 weeks, 22% of the patients had a </=15% DLCO decline. None of the patients reported increased dyspnea during follow-up. Risk factors for pulmonary function changes after treatment with RTX were cigarette smoking, repeated administration of the drug, and co-medication with Prednisone. CONCLUSION: Although no cases of symptomatic lung injury were observed, the progressive DLCO decline seems to indicate the presence of subclinical RTX-induced pulmonary toxicity.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Department of Biomedicine, University Hospital Basel > Rheumatology (Kyburz)
UniBasel Contributors:Kyburz, Diego
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1522-9629 (Electronic) 1094-5539 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:05 Jan 2019 11:33
Deposited On:05 Jan 2019 11:33

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