ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2299

Real-world clinical effectiveness of rituximab rescue therapy in patients with progressive interstitial lung disease associated with primary sjögren’s syndrome

Paula Estrada-Alarcón1, Delia Reina2, JUAN JOSE ALEGRE SANCHO3, Montserrat Roig Kim4, martí Aguilar-Coll5, Laia De Daniel Bisbe4, Aina Fabregat5, Monica Cubells5 and Javier Narváez6, 1Hospital de San Juan Despí Moisès Broggi, Barcelona, Spain, 2Complex Hospitalari Universitari Moisès Broggi, Barcelona, Spain, 3Department of rheumatology. Hospital Universitario Doctor Peset, Valencia, Spain, 4Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain, 5Hospital Universitari de Bellvitge, Barcelona, Spain, 6Hospital Universitario de Bellvitge, Barcelona, Spain

Meeting: ACR Convergence 2025

Keywords: , ,

Session Information

Date: Tuesday, October 28, 2025

Title: (2290–2304) Sjögren’s Disease – Basic & Clinical Science Poster III: Treatment and Trial Outcome Measures

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: To evaluate the real-world, long-term effectiveness of rituximab (RTX) as rescue therapy in patients with primary Sjögren’s syndrome-associated interstitial lung disease (pSS-ILD).

Methods: Multicentre observational retrospective longitudinal study of a cohort of pSS-ILD patients who initiated RTX due to progressive or refractory ILD despite treatment with glucocorticoids and conventional immunosuppressants.

Results: To date, 16 patients have been treated with RTX. The main demographic, clinical, functional, serological, and therapeutic characteristics of the entire cohort are summarised in Table 1.The most frequent ILD pattern on high resolution CT-scan was Nonspecific interstitial pneumonia (NSIP) (88%), while lymphoid interstitial pneumonia (LIP) and combined pulmonary fibrosis and emphysema were each observed in one patient (6%). The median follow-up from ILD diagnosis to the last visit was 55.2 months (IQR: 30.3–69.2).RTX was administered in combination with mycophenolate mofetil (31%), azathioprine (19%), or tacrolimus (13%), while one patient (6%) received RTX as monotherapy. Four patients (25%) were treated concurrently with antifibrotic agents (nintedanib, n=3; pirfenidone, n=1).At last follow-up, 7 patients (44%) remained on RTX. Treatment was discontinued in 9 patients (56%) due to lack of efficacy (n=3; 19%), death (n=3; 19%), lung transplantation (n=2; 13%), or adverse events (n=1; 6%).Among patients who continued RTX, mean declines in %FVC and %DLCO from ILD diagnosis to RTX initiation were –11.7% and –11.4%, respectively, followed by mean improvements of +7.8% (FVC) and +6.3% (DLCO) from RTX initiation to the last available follow-up. However, these improvements did not reach statistical significance (p=0.31 for FVC; p=0.34 for DLCO). Adverse events were reported in 5 patients (31%), mostly consisting of non-severe infections.

Conclusion: RTX achieved stabilisation or improvement in only 44% of patients, indicating limited overall effectiveness and underscoring the need for more effective therapeutic strategies in progressive pSS-ILD.

Supporting image 1

Disclosures: P. Estrada-Alarcón: None; D. Reina: None; J. ALEGRE SANCHO: None; M. Roig Kim: None; m. Aguilar-Coll: None; L. De Daniel Bisbe: None; A. Fabregat: None; M. Cubells: None; J. Narváez: None.

To cite this abstract in AMA style:

Estrada-Alarcón P, Reina D, ALEGRE SANCHO J, Roig Kim M, Aguilar-Coll m, De Daniel Bisbe L, Fabregat A, Cubells M, Narváez J. Real-world clinical effectiveness of rituximab rescue therapy in patients with progressive interstitial lung disease associated with primary sjögren’s syndrome [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/real-world-clinical-effectiveness-of-rituximab-rescue-therapy-in-patients-with-progressive-interstitial-lung-disease-associated-with-primary-sjogrens-syndrome/. Accessed .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/real-world-clinical-effectiveness-of-rituximab-rescue-therapy-in-patients-with-progressive-interstitial-lung-disease-associated-with-primary-sjogrens-syndrome/