Rituximab-induced subacute interstitial pneumonitis: A case report and review of literature

Subramanian, Murali; Manjunath, R; Kilara, Nalini; Rao, K N Mohan

doi:10.4103/0973-1482.73356

Cited by 6 publications

(8 citation statements)

References 14 publications

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“…Recently, an increasing number of case reports about additional and more concerning RTX-related IP have been described ( 19 – 24 ). The pooled incidence of IP in CHOP therapy increased from 1.0% to 7.0% following the addition of RTX to CHOP.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Risk Factors and Incidence of Interstitial Pneumonia With CHOP-Like Regimens for Non-Hodgkin Lymphoma

et al. 2022

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ObjectivesInterstitial pneumonitis (IP), a potentially fatal complication of non-Hodgkin Lymphoma (NHL) patients received CHOP (cyclophosphamide and doxorubicin and vincristine and prednisone)-like chemotherapy, negatively affected patients’ clinical outcome and quality of life. We aimed to explore patient-related, disease-related and drug-related risk factors associated with IP and gain a better understanding of the incidence in NHL patients.MethodsDatabases, including PubMed, Ovid, China National Knowledge Internet (CNKI), and Wanfang Database from inception to January 20, 2022, were searched to identify studies evaluating the risk factors and incidence of IP. The included studies were assessed by Newcastle-Ottawa Quality Scale and above 7 points was considered high quality. The statistical analysis of risk factors was assessed by RevMan software (version 5.3) and incidence of IP was calculated by R software (version 4.1.2). Fixed-or random-effects models were applied to estimated the relative risks (RRs) and 95% confidence interval (Cl).ResultsA total of 12 studies comprised of 3423 NHL patients were included in the analysis. Among the 3 available patient-related risk factors, 6 disease-related risk factors and 3 drug-related risk factors, it was found that only drug-related risk factors were significantly associated with IP development: pegylated liposomes doxorubicin (PLD) replacement (RR = 3.25, 95% CI = 1.69-6.27, I2 =64%), rituximab (RTX) addition (RR = 4.24, 95% CI = 2.58-6.96, I2 =0) and granulocyte colony stimulating factor (G-CSF) administration (RR = 5.80, 95% CI = 3.05-11.05, I2 =0). The pooled incidence of CHOP, R-CHOP, and R-CDOP regimen was 1.0% (95% CI 0.00-0.01, I2 = 8%), 7.0% (95% CI 0.05-0.09, I2 = 64%) and 22.0% (95% CI 0.13-0.32, I2 = 87%) respectively.ConclusionPLD replacement, RTX addition and G-CSF administration were significant risk factors of IP for NHL patients received the CHOP-like chemotherapy. Clinicians should focus on these patients to detect and treat the IP development timely, which might bring benefit in patients’ survival.Systematic Review RegistrationPROSPERO, identifier CRD42022309884.

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Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Risk Factors and Incidence of Interstitial Pneumonia With CHOP-Like Regimens for Non-Hodgkin Lymphoma

et al. 2022

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“…Rituksimab klasik tedavilere yanıtsız veya konvansiyonel ilaç tedavisi altında nüks gelişen, sistemik kortikosteroid ve diğer immünsüpresanların kontrendike olduğu veya ciddi yan etkiler nedeniyle bu tedavilerin sonlandırılması gereken durumlarda tedavi seçeneği olarak tercih edilir (5) . Rituksimab lenfoma, İTP, nefrotik sendrom ve birçok romatolojik hastalığın tedavisinde kullanılmaktadır (7)(8)(9)(10) . Olgumuzda ise Rituksimab transvers myelit tedavisinde kullanılmıştır.…”

Section: Discussionunclassified

“…Destek tedavi olarak oksijen tedavisi ve inhale bronkodilatör tedavi önerilmektedir (1)(2)(3)(4) . Olgumuzda olduğu gibi yapılan birçok çalışmada Rituksimab tedavisinin sonlandırılması ve metilprednizolon başlanmasından sonra hastalarda klinik ve radyolojik bulgularında düzelme sağlanmıştır (7,9,11) . Olguların çoğunluğunda ilk bir ay içinde klinik ve radyolojik düzelme olduğu bildirilmiştir (9)(10)(11) .…”

Section: Discussionunclassified

Rituksimab-Related Interstitial Lung Disease

Avcı¹,

Erturk²,

Çalıkoğlu³

et al. 2020

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Rituximab is a monoclonal antibody which is developed against CD 20 antigen, increasingly used nowadays. While it is used in the treament of the diseases such as lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, transverse myelitis; can also cause interstitial lung disease. A 59 year old female patient who has been followed up with the disease of transverse myelitis and receiving rituximab therapy, applied to the emergency department with labored breath, cough, and fever after drug use. As a result of clinical and radiological evaluations, the patient has diagnosed as drug-related interstitial lung disease. One month after the termination of rituximab therapy and the start of methylprednisolone, the patient’s clinical and radiological findings improved. In conclusion, while investigating the primary cause in interstitial lung disease, the drugs used by the patient should be questioned in this respect and it should be kept in mind that many other drugs such as rituximab can be involved in the etiology.

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“…Rituximab has been licensed for use in adults with CD20-positive B-cell lymphoma or rheumatoid arthritis, but it has also been used for off-label indications that include refractory non-Hodgkin lymphoma, leukaemia, haemophilia, chronic immune thrombocytopaenic purpura, mixed cryoglobulinaemia and nephrotic syndrome. The complications of treatment with monoclonal antibodies to CD20 have included late onset neutropaenia, especially after stem-cell transplantation and in rheumatic diseases, 124 hepatitis B virus reactivation, 125 infection, 126 interstitial pneumonitis, 127 intestinal perforation 128 and possible multifocal leucoencephalopathy associated with activation of a latent polyoma virus (JC virus). 129,130 Complications have typically been infrequent and mild in clinical trials, and they have mainly been infusion reactions, bacterial infections, neutropaenia, anaemia, rash, fever, diarrhoea and reactivation of viral infections.…”

Section: -82mentioning

confidence: 99%

Systematic review: managing suboptimal treatment responses in autoimmune hepatitis with conventional and nonstandard drugs

Selvarajah

Montano‐Loza

Czaja

2012

Aliment Pharmacol Ther

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Rituximab-induced subacute interstitial pneumonitis: A case report and review of literature

Cited by 6 publications

References 14 publications

Meta-Analysis of Risk Factors and Incidence of Interstitial Pneumonia With CHOP-Like Regimens for Non-Hodgkin Lymphoma

Meta-Analysis of Risk Factors and Incidence of Interstitial Pneumonia With CHOP-Like Regimens for Non-Hodgkin Lymphoma

Rituksimab-Related Interstitial Lung Disease

Systematic review: managing suboptimal treatment responses in autoimmune hepatitis with conventional and nonstandard drugs

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