Evidence map›Paper›PMID 33274857›Full record

ArticleACR open rheumatology2021

Rituximab Versus Mycophenolate in the Treatment of Recalcitrant Connective Tissue Disease-Associated Interstitial Lung Disease.

Lisa Zhu, Melody P Chung, Laurence Gagne, Haiwei H Guo, Zachary Guenther, Shufeng Li, Susan Jacobs, Julie Morisset, Joshua J Mooney, Rishi Raj and 1 more

Open access · goldAbstract read
In one paragraph

Article in ACR open rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Guideline
  2. Combination antifibrotic and immunosuppressive therapy in progressive fibrosing ILD.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2026
    Article
  3. Review
  4. Review
  5. Article
  6. Immunomodulatory treatment of interstitial lung disease.Therapeutic advances in respiratory disease
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Lisa ZhuStanford University, Stanford, California, United States.ORCID https://orcid.org/0000-0001-9858-7265
Melody P ChungStanford University, Stanford, California, United States.ORCID https://orcid.org/0000-0003-0221-4910
Laurence GagneCentre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada.
Haiwei H GuoStanford University, Stanford, California, United States.ORCID https://orcid.org/0000-0001-5511-1750
Zachary GuentherUniversity of Calgary, Calgary, Alberta, Canada.
Shufeng LiStanford University, Stanford, California, United States.
Susan JacobsStanford University, Stanford, California, United States.
Julie MorissetCentre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada.
Joshua J MooneyStanford University, Stanford, California, United States.ORCID https://orcid.org/0000-0002-4687-194X
Rishi RajStanford University, Stanford, California, United States.
Lorinda ChungStanford University, Stanford, California, United States.ORCID https://orcid.org/0000-0003-0072-6939
Stanford University · USCentre Hospitalier de l’Université de Montréal · CAUniversity of Calgary · CA

Funding

Training Program in Adult and Pediatric RheumatologyT32AR050942 · NIAMS · STANFORD UNIVERSITY · PI LEWIS, DAVID BRAM, ROBINSON, WILLIAM H · 2005 to 2025
$6.6M
Scleroderma Research FoundationTraining Program in Adult and Pediatric Rheumatology 5T32AR050942-12
6 · The paper itself

Abstract

objectiveInterstitial lung disease (ILD) is a major cause of morbidity and mortality in connective tissue diseases (CTDs). We aimed to assess the effect of rituximab ± mycophenolate mofetil (MMF) compared with MMF on pulmonary function and prednisone dosage in patients with CTD-related ILD (CTD-ILD).

methodsThis retrospective study included 83 patients from Stanford and Centre Hospitalier de l'Universite de Montreal. Fifteen patients received rituximab ± MMF (rituximab group), and 68 patients received MMF only (control group).

resultsMedian ILD duration at the start of treatment was longer in the rituximab group at 47 months (range: 4-170) versus 6.5 months (range: 0-164) in controls. Forced vital capacity (FVC) decreased by 3.0% (range: 11%-21%) after treatment in the rituximab group, whereas it increased by 2.0% (range: 14%-25%) in the control group (p = 0.025). Diffusing capacity of carbon monoxide (DLCO) decreased by 3.0% (range: 10%-12%) after treatment in the rituximab group, whereas it increased by 4.5% (range: 30%-36%) in the control group (p = 0.046). Mixed model analysis controlling for ILD duration, baseline DLCO, systemic sclerosis, pulmonary hypertension, and prednisone use showed no significant difference in FVC or DLCO between groups at 6 months or 1 year. The average daily prednisone dose score decreased after treatment in the rituximab group, whereas it remained unchanged in the control group (p = 0.017).

conclusionRituximab ± MMF did not significantly change pulmonary function compared with MMF alone, but it did result in a relative decrease in average daily prednisone dose in a population with recalcitrant CTD-ILD.

Identifiers

PMID33274857
PMCPMC7811692
OpenAlexW3110320764

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.