Rituximab as the first-line therapy in anti-synthetase syndrome-related interstitial lung disease

Long-lasting improvement of refractory antisynthetase syndrome with tocilizumab: a report of two cases

“…In severe disease, conventional DMARDs are often insufficient and the use of anti-TNF, MMF, ciclosporin or cyclophosphamide has not allowed us to solve this conundrum. Rituximab has gained interest in this setting and is even regarded as first-line therapy by some, 6 but his role in interstitial lung disease remains disputed. 3 4 Recently, use of Janus kinase inhibitors and even CD19-targeting chimeric antigen receptor (CAR)-T cells have been published for refractory cases.…”

“… 4 5 It is nevertheless regarded as the first-line therapy in this indication by some authors. 6 Finally, even though joint manifestations are common, they are often regarded as minor with no specific therapeutic recommendation. 3 Hydroxychloroquine, methotrexate, rituximab and antitumour necrosis factor (anti-TNF) have been reported to show some benefits on both joint and muscle involvement, whereas anti-TNF are beneficial on joint manifestations but have failed to show any efficacy on muscle.…”

“…4 5 It is nevertheless regarded as the first-line therapy in this indication by some authors. 6 Finally, even though joint manifestations are common, they are often regarded as minor with no specific…”