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J Rheumatol:利妥昔单抗和环磷酰胺治疗抗合成酶综合征相关性ILD

2020-03-21 xiangting MedSci原创

在ASyS相关性ILD患者中,尽管6个月时PFS相似,但与CYC相比,RTX的2年PFS更佳。

抗合成酶综合征(ASyS)相关性间质性肺病(ILD)预后较差。静脉注射环磷酰胺(CYC)和利妥昔单抗(RTX)是目前中至重度ILD的主要治疗方法。这项研究比较了CYC然后进行标准免疫抑制治疗(IST)vs. RTx对ASyS相关性ILD的疗效。

于2003年至2016年在3个三级治疗中心进行了这项观察性回顾研究。纳入接受CYC或RTX治疗并至少随访6个月的全部ASyS相关性ILD患者。在6个月和2年时评估根据美国胸科学会指南定义的肺部无进展生存率(PFS)。记录所有的严重不良事件。

纳入62例患者。34例患者接受了2-12次的每月CYC静脉冲击治疗,30例(88%)随后接受了标准IST治疗。RTX组包括28例患者,在开始的第1天至第15天输注后,26例患者(93%)每6个月重复进行一次RTX治疗,15例患者(54%)同时接受IST治疗。两组的类固醇中位剂量相似。尽管RTX和CYC的6个月PFS相似(分别为92%vs.81%),但在2年时RTX的PFS更好(危险比=0,263 [0,094-0,732],p=0.011)。有趣的是,基线DLCO较低可以独立预测2年PFS不良(0.965 [0.936-0.995],p=0.023)。两组的FVC和DLCO均有改善,差异没有显著性。两组的严重不良事件相似。

在ASyS相关性ILD患者中,尽管6个月时PFS相似,但与CYC相比,RTX的2年PFS更佳。

原始出处:

Vincent Langlois. Rituximab and Cyclophosphamide in anti-synthetase syndrome (ASyS)-related ILD: an observational retrospective study. J Rheumatol. March 2020.

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