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Article Dans Une Revue Respiratory Research Année : 2018

Rituximab for auto-immune alveolar proteinosis, a real life cohort study

Jacques Cadranel
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Vincent Cottin

Résumé

Background: Whole lung lavage is the current standard therapy for pulmonary alveolar proteinosis (PAP) that is characterized by the alveolar accumulation of surfactant. Rituximab showed promising results in auto-immune PAP (aPAP) related to anti-GM-CSF antibody.Methods: We aimed to assess efficacy of rituximab in aPAP in real life and all patients with aPAP in France that received rituximab were retrospectively analyzed.Results: Thirteen patients were included. No patients showed improvement 6 months after treatment, but, 4 patients (30%) presented a significant decrease of alveolar-arterial difference in oxygen after 1 year. One patient received lung transplantation and one patient was lost of follow-up within one year. Although a spontaneous improvement cannot be excluded in these 4 patients, improvement was more frequent in patients naive to prior specific therapy and with higher level of anti-GM-CSF antibodies evaluated by ELISA. No serious adverse event was evidenced. Conclusions: These data do not support rituximab as a second line therapy for patients with refractory aPAP.
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Dates et versions

hal-01791591 , version 1 (28-05-2018)

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Berenice Soyez, Raphael Borie, Cedric Menard, Jacques Cadranel, Leonidas Chavez, et al.. Rituximab for auto-immune alveolar proteinosis, a real life cohort study. Respiratory Research, 2018, 19 (1), pp.74. ⟨10.1186/s12931-018-0780-5⟩. ⟨hal-01791591⟩
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