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Abatacept in interstitial lung disease associated with rheumatoid arthritis: national multicenter study of 263 patients

Abstract: Objective. To assess the efficacy of abatacept (ABA) in RA patients with interstitial lung disease (ILD) (RA-ILD). Methods. This was an observational, multicentre study of RA-ILD patients treated with at least one dose of ABA. ILD was diagnosed by high-resolution CT (HRCT). We analysed the following variables at baseline (ABA initiation), 12 months and at the end of the follow-up: Modified Medical Research Council (MMRC) scale (1-point change), forced vital capacity (FVC) or diffusion lung capacity for carbon monoxide (DLCO) (improvement or worsening 10%), HRCT, DAS on 28 joints evaluated using the ESR (DAS28ESR) and CS-sparing effect. Results. We studied 263 RA-ILD patients [150 women/113 men; mean (S.D.) age 64.6 (10) years]. At baseline, they had a median duration of ILD of 1 (interquartile range 0.25?3.44) years, moderate or severe degree of dyspnoea (MMRC grade 2, 3 or 4) (40.3%), FVC (% of the predicted) mean (S.D.) 85.9 (21.8)%, DLCO (% of the predicted) 65.7 (18.3) and DAS28ESR 4.5 (1.5). The ILD patterns were: usual interstitial pneumonia (UIP) (40.3%), non-specific interstitial pneumonia (NSIP) (31.9%) and others (27.8%). ABA was prescribed at standard dose, i.v. (25.5%) or s.c. (74.5%). After a median follow-up of 12 (6?36) months the following variables did not show worsening: dyspnoea (MMRC) (91.9%); FVC (87.7%); DLCO (90.6%); and chest HRCT (76.6%). A significant improvement of DAS28ESR from 4.5 (1.5) to 3.1 (1.3) at the end of follow-up (P<0.001) and a CS-sparing effect from a median 7.5 (5?10) to 5 (2.5?7.5) mg/day at the end of follow-up (P<0.001) was also observed. ABA was withdrawn in 62 (23.6%) patients due to adverse events (n¼30), articular inefficacy (n¼27), ILD worsening (n¼3) and other causes (n¼2). Conclusion. ABA may be an effective and safe treatment for patients with RA-ILD.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Rheumatology 2020;59:3906-3916

Editorial: Oxford University Press

 Año de publicación: 2020

Nº de páginas: 11

Tipo de publicación: Artículo de Revista

 DOI: 10.1093/rheumatology/keaa621

ISSN: 1462-0324,1462-0332

Url de la publicación: https://doi.org/10.1093/rheumatology/keaa621

Autores/as

CARLOS FERNÁNDEZ-DÍAZ

SANTOS CASTAÑEDA

RAFAEL B MELERO-GONZÁLEZ

FRANCISCO ORTIZ-SANJUÁN

ANTONIO JUAN-MAS

CARMEN CARRASCO-CUBERO

IVETTE CASAFONT-SOLÉ

ALEJANDRO OLIVÉ

SAMANTHA RODRÍGUEZ-MUGURUZA

RAQUEL ALMODÓVAR-GONZÁLEZ

RAUL CASTELLANOS-MOREIRA

SEBASTIAN C RODRÍGUEZ-GARCÍA

CLARA AGUILERA-CROS

IGNACIO VILLA

SERGIO ORDÓÑEZ-PALAU

ENRIQUE RAYA-ALVAREZ

JAVIER LORICERA GARCIA

RICARDO BLANCO ALONSO