Rituximab in the treatment of Jo1 antibody-associated antisynthetase syndrome

• Verfasst von: Bauhammer, Jutta Sinikka [VerfasserIn]
• Verfasst von: Blank, Norbert [VerfasserIn]
• Verfasst von: Max, Regina [VerfasserIn]
• Verfasst von: Lorenz, Hanns-Martin [VerfasserIn]
• Verfasst von: Wagner, Ulrich [VerfasserIn]
• Verfasst von: Krause, Dietmar Michael Josef [VerfasserIn]
• Verfasst von: Fiehn, Christoph [VerfasserIn]
• Titel: Rituximab in the treatment of Jo1 antibody-associated antisynthetase syndrome
• Titelzusatz: anti-Ro52 positivity as a marker for severity and treatment response
• Verf.angabe: Jutta Bauhammer, Norbert Blank, Regina Max, Hanns-Martin Lorenz, Ulrich Wagner, Dietmar Krause, and Christoph Fiehn
• E-Jahr: 2016
• Jahr: April 20, 2016
• Umfang: 9 S.
• Fussnoten: Gesehen am 23.04.2020
• Titel Quelle: Enthalten in: The journal of rheumatology
• Ort Quelle: Toronto, Ont., 2001
• Jahr Quelle: 2016
• Band/Heft Quelle: 43(2016), 8, Seite 1566-1574
• ISSN Quelle: 1499-2752
• DOI: doi:10.3899/jrheum.150844
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1695798481

Abstract

Objective Rituximab (RTX) has been used successfully for the treatment of severe Jo1 antibody-associated antisynthetase syndrome. The aim of this retrospective study was to evaluate the effect of RTX in severe Jo1 antisynthetase syndrome and determine predictive factors for response. - Methods There were 61 patients with Jo1 antisynthetase syndrome identified; 18 of these received RTX. One patient was lost to followup. The remaining 17 patients and 30 out of 43 patients who were treated with conventional immunosuppressive (IS) drugs were followed for a mean of 35 months and 84 months, respectively. - Results Polymyositis/dermatomyositis (95%) and interstitial lung disease (ILD; 66%) were the dominant clinical manifestations. Detection of anti-Ro52 antibodies (43%) was significantly associated with acute-onset ILD (p = 0.016) with O2 dependency, and patients with high concentrations of anti-Ro52 (20%) had the highest risk (p = 0.0005). Sixteen out of 18 patients (89%) showed a fast and marked response to RTX. Among those patients who were highly positive for anti-Ro52, response to RTX was seen in 7 out of 7 cases (100%), but no response to cyclophosphamide (n = 4), cyclosporine A (n = 3), azathioprine (n = 9), methotrexate (n = 5), or leflunomide (n = 2) was observed. One patient treated with RTX died of pneumonia. - Conclusion RTX is effective in the treatment of severe forms of Jo1 antisynthetase syndrome. In our retrospective study, the presence of high anti-Ro52 antibody concentrations predicts severe acute-onset ILD and nonresponse to IS drugs. In contrast to conventional IS, RTX is equally effective in patients with Jo1 antisynthetase syndrome, independent of their anti-Ro52 antibody status.