Background

There are chronic forms of hypersensitivity pneumonitis (cHP) that can progress to pulmonary fibrosis. There is no recommended treatment for patients whose respiratory condition continues to deteriorate in spite of antigen avoidance. Whether rituximab may be beneficial to patients with cHP is unknown. The aim of this study was to describe the course of 20 patients with cHP under rituximab therapy.

Methods

This retrospective study was conducted from November 2018 to July 2019 in 7 French university hospitals. Forced Vital Capacity (FVC) was measured 6 months before rituximab therapy onset (M − 6), at rituximab onset (M0), and 6 months later (M+6).

Results

FVC decreased significantly in the 6 months preceding the introduction of rituximab (65% [44; 112%] at M − 6 versus 59% [39; 102%] at M0; p = 0.0001), but it did not differ significantly from that at 6 months after the introduction of rituximab (61% [38; 99%]). The decline in FVC between M0 and M+6 (−3% [-15; +19%]) was significantly less than between M − 6 and M0 (−8% [-21; 0%]) (p = 0.0002). Between M0 (37% [16; 73%]) and M + 6 (45% [15; 70%]), the median DLCO remained stable (p = 0.12). DLCO improved at M+6 in 5 of the 8 patients (63%) for whom a DLCO value was available at M+6 improved their DLCO.

Conclusion

Rituximab seems well tolerated, and may lead to stabilization or improvement of lung function in some patients.

中文翻译：

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利妥昔单抗对慢性超敏性肺炎（cHP）患者的疗效和安全性：一项回顾性，多中心，观察性研究

背景

慢性过敏性肺炎（cHP）有慢性形式，可发展为肺纤维化。尽管避免了抗原治疗，但对于呼吸状况持续恶化的患者，没有建议的治疗方法。利妥昔单抗是否可能对cHP患者有益。这项研究的目的是描述使用利妥昔单抗治疗的20例cHP患者的病程。

方法

这项回顾性研究于2018年11月至2019年7月在法国7所大学医院进行。在利妥昔单抗治疗开始前6个月（M-6），利妥昔单抗发作（M0）和6个月后（M + 6）测量强制肺活量（FVC）。

结果

FVC在引入利妥昔单抗前的6个月中显着下降（在M-6时为65％[44; 112％]，而在M0时为59％[39; 102％]； p = 0.0001），但无明显差异。引入利妥昔单抗后6个月时（61％[38; 99％]）。M0和M + 6之间的FVC下降（-3％[-15; + 19％]）明显小于M-6和M0之间的FVC（−8％[-21; 0％]）（p = 0.0002） 。在M0（37％[16; 73％]）和M + 6（45％[15; 70％]）之间，中位数DLCO保持稳定（p = 0.12）。在M + 6有DLCO值的8例患者中，有5例（63％）DLCO有所改善。

结论

利妥昔单抗似乎耐受良好，并可能导致某些患者的肺功能稳定或改善。