Abstract
Introduction: In the chronic HP the autoreactive B lymphocytes mediated by T cells may also play a role in inflammatory reaction that could justify the use of rituximab.
Objectives: To study the effectiveness of rituximab for retarding disease progression in the chronic HP.
Methods: Two doses of 1000 mg of Rituximab were administered compassionately to 5 patients diagnosed of chronic HP. The FVC, DLCO and 6minWT were measured at 15 days and 1, 3, 6 and 11 months. Evolutionary data were compared with those of 5 patients with chronic HP that were controlled in the outpatient clinics and that had been treated with usual therapeutic measures.
Results: The median age of patients treated with rituximab was 72 years (p25-p75 72-73). All patients were male and 80% of them were ex smokers (> 10 paq/ year). They also had a median FVC and DLCO of 59% and 31% respectively before rituximab. In the 6minWT they had walked a median of 396 (324-463) meters. After the treatment with rituximab they had a median decrease of 9.3 % (-11.8 – 3.2) and 2.2 % (-8.4 – -1.7) of the FVC and DLCO respectively. The 5 patients with HP that were controlled in the outpatient clinics and that had been treated with usual measures, after 11 months of follow up showed a decrease of 4.4% (-8.5 – 1.0) in the FVC and 5.4% (-6.0 – -3.4) in the DLCO.
Conclusion: Rituximab may be a valid therapeutic alternative in a subset of patients with chronic HP.
- Copyright ©ERS 2015