Baricitinib in Rheumatoid Arthritis - Interstitial Lung Disease. National Multicenter Study of 72 Patients

Ana Serrano-Combarro¹, Belén Atienza-Mateo², Jesús Alejandro Valero Jaimes³, Marta Pastor-Mena⁴, Rafael Benito Melero-Gonzalez⁵, María Martín López⁶, Santos Castañeda⁷, Jesús Loarce⁸, César Antonio Egües Dubuc⁹, Natalia Mena Vázquez¹⁰, Carmen Carrasco-Cubero¹¹, Carolina Perez-Garcia¹², Juan M Blanco Madrigal¹³, Nuria Vegas Revenga¹⁴, Lorena Pérez Albadalejo¹⁵, Rafaela Ortega-Castro¹⁶, Desiree Palma¹⁷, Ana Fernández-Ortiz¹⁸, Maria López Lasanta¹⁹, Marta Garijo Bufort²⁰, Ivette Casafont-Sole²¹, Andrea García-Valle²², Maria Paz Martinez-Vidal²³, Bryan Josué Flores Robles²⁴, EVELIN CERVANTES PEREZ²⁵, Ignacio Brana Abascal²⁶, Sara María Rojas Herrera²⁷, Juan Camilo Sarmiento-Monroy²⁸, Virginia Ruiz-Esquide²⁹, JOSE RAMON LAMUA RIAZUELO³⁰, Uxue Astigarraga-Urquia³¹, Diego Ferrer³² and Ricardo Blanco-Alonso³³, ¹Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain, ²Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Cantabria, Spain, ³Zumarraga Hospital, Zumarraga, Spain, ⁴Hospital de Jeréz de la Frontera, Cadiz, Spain, ⁵CHU Ourense, O Carballino, Spain, ⁶General University Hospital of Ciudad Real, Ciudad de México, Spain, ⁷Hospital Universitario de la Princesa, Madrid, Spain, ⁸Ramón y Cajal University Hospital, Madrid, Madrid, Spain, ⁹Hospital Universitario de Donostia, Donostia, Pais Vasco, Spain, ¹⁰IBIMA, Málaga, Andalucia, Spain, ¹¹Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain, ¹²Hospital del Mar, Barcelona, Spain, ¹³BASURTO UNIVERSITY HOSPITAL, Bilbao, Spain, ¹⁴Hospital Galdakao- Usansolo, Galdakao, Spain, ¹⁵Hospital Universitario de Jaén, Jaén, Spain, ¹⁶Hospital Reina Sofía, Cordoba, Andalucia, Spain, ¹⁷Hospital Rafael Méndez, Lorca, Murcia, Spain, ¹⁸Hospital Universitario de Badajoz, Badajoz, Spain, ¹⁹Hospital Vall d�Hebron, Barcelona, Spain, ²⁰Hospital de Sagunto, Valencia, Spain, ²¹Hospital Universitari Germans Trias i Pujol, Badalona, Spain, ²²Hospital General Río Carrión, Palencia, Spain, ²³Hospital San Juan de Alicante, Alicante, Spain, ²⁴Hospital San Pedro, Logroño, Spain, ²⁵Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Galicia, Spain, ²⁶Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain, ²⁷Hospital de Mérida, Badajoz, Spain, ²⁸Hospital Clínic Barcelona, Barcelona, Spain, ²⁹Hospital Clinic de Barcelona, Barcelona, Spain, ³⁰Hospital Universitario del Henares, Madrid, Spain, ³¹Hospital Universitario de Navarra, Pamplona, Spain, ³²Division of Pneumology, Hospital Universitario Marqués de Valdecilla, Santander, Spain, ³³Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: autoimmune diseases, rheumatoid arthritis

Session Information

Date: Saturday, November 16, 2024

Title: RA – Diagnosis, Manifestations, & Outcomes Poster I

Session Type: Poster Session A

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

Background/Purpose: Interstitial lung disease (ILD) is a severe extraarticular manifestation of rheumatoid arthritis (RA) that determines a worse prognosis, leading the cause of mortality in RA patients, second only to cardiovascular disease. Abatacept and rituximab are the recommended drugs. JAK inhibitors (JAKi) have demonstrated efficacy in RA. The JAKi approved by the Food and Drugs Administration (FDA) and the European Medicines Agency (EMA) for the treatment of RA are tofacitinib (TOFA), baricitinib (BARI), upadacitinib and filgotinib. The evidence on efficacy of BARI in RA-ILD is growing. Our objective is to assess a) the effectiveness and b) the safety of BARI in AR-ILD patients.

Methods: National multicenter study of 72 RA-ILD patients on treatment with BARI. We analyzed the following outcomes from baseline:
a)
forced vital capacity (FVC)
,
b)
diffusing capacity of the lungs for carbon monoxide
(DLCO),
c)
chest
high resolution computed tomography (HRCT), d)
dyspnea (modified Medical Research Council scale), e) arthritis activity (DAS28-ESR or clinical records), and f) sparing corticosteroids effect.

Results: We studied 72 patients (52 women / 20 men; mean age 68
±
10 years) from clinical practice on treatment with BARI. Baseline demographic and clinical characteristics are shown in Table.
All
patients had received disease-modifying antirheumatic drugs (DMARDs) before BARI [Methotrexate (62; 86%), Leflunomide (51; 70%), Sulfasalazine (19; 26%), Abatacept (45; 63%), Tocilizumab (25; 35%), Adalimumab (22; 31%) and Rituximab (17; 24%)]. Median [IQR] ILD duration up to BARI initiation was of
25 [13-63]
months.
Mean baseline values of FVC and DLCO (% predicted) were 86
±
28
and 69
±
20, respectively. Patients were followed-up for a median [IQR] of 14 [6-42] months. The evolution of FVC and DLCO remained stable during the first 24 months (Figure). At the end of the follow-up, available chest HRCT images improved/ stabilized
in 72% of patients. Stabilization or improvement of dyspnea was found in 90% of patients. Most patients showed articular remission or low activity. BARI was withdrawn in 32 (46%) patients due to articular inefficacy (n=22), lung inefficacy (n=5), development of hypersensitivity pneumonitis (n=1), ocular involvement (n=1), acute myocardial infarction (n=1), respiratory infection (n=1) and appearance of brain cancer (n=1).

Conclusion: BARI might be safe and useful in controlling both pulmonary and joint disease in RA-ILD patients.

Table. Baseline characteristics of RA-ILD patients treated with BARI.

Figure. Evolution of pulmonary function tests (mean % of the predicted FVC and DLCO) in RA-ILD patients with BARI therapy at baseline and 24 months.

Disclosures: A. Serrano-Combarro: None; B. Atienza-Mateo: None; J. Valero Jaimes: None; M. Pastor-Mena: None; R. Melero-Gonzalez: None; M. Martín López: None; S. Castañeda: Bristol-Myers Squibb(BMS), 2, 6, Eli Lilly, 2, 6, Merck/MSD, 2, 5, 6, Pfizer, 5, Roche, 2, 6, UCB, 2, 5; J. Loarce: None; C. Egües Dubuc: None; N. Mena Vázquez: None; C. Carrasco-Cubero: None; C. Perez-Garcia: None; J. Blanco Madrigal: None; N. Vegas Revenga: None; L. Pérez Albadalejo: None; R. Ortega-Castro: None; D. Palma: None; A. Fernández-Ortiz: None; M. López Lasanta: None; M. Garijo Bufort: None; I. Casafont-Sole: None; A. García-Valle: None; M. Martinez-Vidal: None; B. Flores Robles: None; E. CERVANTES PEREZ: None; I. Brana Abascal: None; S. Rojas Herrera: None; J. Sarmiento-Monroy: None; V. Ruiz-Esquide: None; J. LAMUA RIAZUELO: None; U. Astigarraga-Urquia: None; D. Ferrer: None; R. Blanco-Alonso: AbbVie, 2, 5, 6, Bristol-Myers Squibb, 2, 6, Galapagos, 6, Janssen, 2, 6, Lilly, 2, 6, MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6.

To cite this abstract in AMA style:

Serrano-Combarro A, Atienza-Mateo B, Valero Jaimes J, Pastor-Mena M, Melero-Gonzalez R, Martín López M, Castañeda S, Loarce J, Egües Dubuc C, Mena Vázquez N, Carrasco-Cubero C, Perez-Garcia C, Blanco Madrigal J, Vegas Revenga N, Pérez Albadalejo L, Ortega-Castro R, Palma D, Fernández-Ortiz A, López Lasanta M, Garijo Bufort M, Casafont-Sole I, García-Valle A, Martinez-Vidal M, Flores Robles B, CERVANTES PEREZ E, Brana Abascal I, Rojas Herrera S, Sarmiento-Monroy J, Ruiz-Esquide V, LAMUA RIAZUELO J, Astigarraga-Urquia U, Ferrer D, Blanco-Alonso R. Baricitinib in Rheumatoid Arthritis – Interstitial Lung Disease. National Multicenter Study of 72 Patients [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/baricitinib-in-rheumatoid-arthritis-interstitial-lung-disease-national-multicenter-study-of-72-patients/. Accessed .

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