Source: Annual Congress 2002 - Interstitial lung disease
Disease area: Interstitial lung diseases

Abstract

We investigated the efficacy of anti-TNF therapy (Infliximab) in three patients with rheumatoid arthritis (RA) complicated by interstitial lung disease (ILD). These patients were no responders to corticosteroids and methotrexate therapy. They were treated with 3 mg/Kg i.v. of Infliximab in 250 cc of saline solution initially, then at week 2-6-14 and subsequently every 8 weeks. Our protocol also included Methotrexate at the dosage of 10 mg/week i.m. During the treatment patients continued their corticosteroid therapy at the higher dose of 12.5 mg respecting the same dosage for the entire period of observation.
After 14 weeks of therapy, all subjects showed a rapid improvement of arthritis but no improvement was observed for the respiratory involvement, lung function tests revealed a reduction of about 10% of VC and the chest HRCT remained unchanged.
The effects on the lung have not been encouraging. although our patient pulmonary manifestations were heterogeneous and advanced. These contrasting clinical responses could be interpreted in different ways: the shortness of the observation period, the insufficient dosage of Infliximab, a too advanced phase of fibrosis or the existence of two different immunological mechanisms for pulmonary fibrosis and the articular involvement in RA. This is the first preliminary report that considered the effects of this therapy in patients affected by interstitial lung disease associated with RA.
Further studies are needed by treating patients with less sever ILD-RA and by using a higher anti-TNF dosage.

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Citations should be made in the following way:
P. Rottoli, E. Bargagli, F. A. Cimmino, M. Galeazzi, R. Marcolongo (Siena, Italy). Infliximab treatment in patients with interstitial lung disease and rheumatoid arthritis. Eur Respir J 2002; 20: Suppl. 38, 3675

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