ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0662

Changes in Treatment Patterns and Their Influence on the Outcome of Systemic Sclerosis-interstitial Lung Disease (SSc-ILD) Patients: An EUSTAR Analysis

Corrado Campochiaro1, Marie-Elise Truchetet2, Madelon Vonk3, Giovanna Cuomo4, Lidia P Ananieva5, Eric Hachulla6, Vanessa Smith7, Ana Maria Gheorghiu8, Radim Becvar9, Nicolas Hunzelmann10, Daniel Furst11, Vera Ortiz-Santamaria12, Patricia Carreira13, Francesco Del Galdo14, marco Matucci Cerinic15 and Anna Maria Hoffmann-Vold16, 1IRCCS San Raffaele Hospital, Unit of Immunology, Rheumatology, Allergy and Rare Disease. Vita-Salute San Raffaele University, Milan, Italy, 2Bordeaux University Hospital, Bordeaux, France, 3Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands, 4Department of Precision Medicine, “Luigi Vanvitelli” University of Campania, Naples, Italy, 5V.A. Nasonova Research Institute Of Rheumatology Russian Federation, Moscow, Russia, 6University of Lille, Lille, France, 7Ghent University Hospital, Gent, Belgium, 8Department of Internal Medicine and Rheumatology, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, 9Institute of Rheumatology, Prague, Czech Republic, Department of Rheumatology, 1st Faculty of Medicine, Charles University, Praha, Czech Republic, 10University of Kšln, Kšln, Germany, 11University of California Los Angeles, Los Angeles, CA, 12University of Granollers, Granollers, Spain, 13Hospital Universitario 12 de Octubre, Madrid, Spain, 14University of Leeds - Leeds Institute of Rheumatic and Muskuloskeletal Medicine, Leeds, United Kingdom, 15Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Milan, Italy, 16Oslo University Hospital, Department of Rheumatology, Oslo, Norway

Meeting: ACR Convergence 2023

Keywords: ,

Session Information

Date: Sunday, November 12, 2023

Title: (0609–0672) Systemic Sclerosis & Related Disorders – Clinical Poster I: Research

Session Type: Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: The treatment armamentarium with immunosuppressive treatments (ISTs) for interstitial lung disease (ILD) in systemic sclerosis (SSc) has greatly expanded. It is to date unclear to which degree and its impact on ILD progression, which is of importance for the management of patients and clinical trials. Here, we assess treatment regimens and its impact on ILD progression and mortality in SSc-ILD.

Methods: SSc patients registered in the EUSTAR database with presence of ILD on imaging, available FVC%, DLCO% predicted and treatments at baseline and at 12 ± 3 months were included. ILD progression was defined as absolute FVC≥5% or DLCO≥10% decline. We segregated treatment regimens into four periods based on patients first assessment: 1) ≤ 2006; 2) 2007-2011; 3) 2012-2016; 4) ≥ 2017 and assessed clinical characteristics and type of IST. Next, we evaluated the impact of ISTs across the periods on ILD progression and a combined morbidity-mortality endpoint (progression and 3-year death). Lastly, we assessed the impact of ISTs on these endpoints in patients with positive anti-topoisomerase I (ATA) and short disease duration (≤60 months since first non-Raynaud’s symptom) in a subgroup analysis. Non-parametric tests were used for multiple group comparisons.

Results: We included 1408 SSc–ILD patients with 122 (8.7%) in period 1; 376 (26.7%) in period 2; 459 (32.6%) in period 3 and 451 (32.0%) in period 4. We did not identify major differences in clinical characteristics across the periods (Table 1); whereas the ISTs changed significantly from 12 % treated with IST in period 1 to 59% in period 4 (Figure 1). When assessing the impact of ISTs across the periods on our endpoints, we did not identify significant impact on ILD progression or the morbidity-mortality (Figure 2). In the subgroup analysis, enriching for progressive patients with short disease duration and ATA, we included 324 (23%) SSc-ILD patients across the 4 periods (4, 32, 120 and 168 in period 1-4). In this analysis, excluding those from period 1 due to low numbers, we identified significantly less ILD progression with 59.4%, 37.5% and 35.1%, respectively (p =0.037) and morbidity-mortality endpoint with 62.5%, 38.3% and 38.7%, respectively (p=0.036).

Conclusion: We show that treatment with immunosuppressives has increased significantly over the past decade, with currently 60% of SSc-ILD patients on IST. This is important knowledge for the design and inclusion of patients into clinical trials. We do not identify an impact on ILD progression in the total cohort but in an enriched population, showing the importance of treatment, specifically of patients at risk for progression.

Supporting image 1

Figure 1. Immunosuppressive therapies across the four periods

Supporting image 2

Figure 2. Outcomes of SSc-ILD patients at first-time assessment across the four periods.

Supporting image 3

Table 1. Clinical and treatment features of SSc-ILD patients at first-time assessment across the four periods

Disclosures: C. Campochiaro: Boehringer Ingelheim, 1, 6, Janssen, 1, 6, Novartis, 1, 6; M. Truchetet: AbbVie/Abbott, 2, 6, Boehringer-Ingelheim, 2, 6, Gilead, 5, 6, Merck/MSD, 6, UCB, 6, 12, support for conferences; M. Vonk: Boehringer Ingelheim, 5, 6, Corbus, 1, EUSTAR, 4, Ferrer, 5, Galapagos, 5, Janssen, 5, 6, MSD, 6, Systemic Sclerosis ERN ReCONNET, 4; G. Cuomo: None; L. Ananieva: None; E. Hachulla: Bayer, 2, CSL Behring, 5, GlaxoSmithKlein(GSK), 2, 5, 6, johnson&Johnson, 2, 5, 6, Novartis, 2, 5, Otsuka, 6, Roche-Chugai, 2, 5, 6, sanofi-genzyme, 2, 5, Sobi, 5; V. Smith: Boehringer Ingelheim, 2, 5, 6, 12, Support for travel, Galapagos, 6, Janssen-Cilag, 1, 2, 5, 6; A. Gheorghiu: AbbVie/Abbott, 2, 6, Boehringer-Ingelheim, 2, 6, Ewopharma, 2, 6, Sandoz, 2, 6; R. Becvar: Boehringer-Ingelheim, 2, GlaxoSmithKlein(GSK), 2; N. Hunzelmann: None; D. Furst: Amgen, 2, 5, Corbus, 2, 5, CSL Behring, 5, Galapagos, 2, 5, Gilead, 5, GSK, 5, Horizon, 5, Novartis, 5, Pfizer, 5, Roche, 5; V. Ortiz-Santamaria: None; P. Carreira: None; F. Del Galdo: AbbVie/Abbott, 5, arxx, 2, AstraZeneca, 2, 5, Boehringer-Ingelheim, 2, 5, capella, 2, Chemomab, 2, GlaxoSmithKlein(GSK), 2, Janssen, 2, Mitsubishi-Tanabe, 2, 5; m. Matucci Cerinic: accelerong, 2, 6, actelion, 2, 6, bayer, 2, 6, biogen, 2, 6, Boehringer-Ingelheim, 2, 6, Chemomab, 2, 6, corbus, 2, 6, CSL Behring, 2, 6, Eli Lilly, 2, 6, galapagos, 2, 6, Inventiva, 2, 6, Janssen, 2, 6, Merck/MSD, 2, 6, Mitsubishi, 2, 6, Pfizer, 2, 6, regeneron, 2, 6, Roche, 2, 6, samsung, 2, 6; A. Hoffmann-Vold: Arxx Therapeutics, 2, Boehringer-Ingelheim, 2, 5, 6, 12, Support for travel, Genentech, 2, Janssen, 2, 5, 6, Medscape, 2, 6, 12, Support for travel, Roche, 2, 6, 12, Support for travel.

To cite this abstract in AMA style:

Campochiaro C, Truchetet M, Vonk M, Cuomo G, Ananieva L, Hachulla E, Smith V, Gheorghiu A, Becvar R, Hunzelmann N, Furst D, Ortiz-Santamaria V, Carreira P, Del Galdo F, Matucci Cerinic m, Hoffmann-Vold A. Changes in Treatment Patterns and Their Influence on the Outcome of Systemic Sclerosis-interstitial Lung Disease (SSc-ILD) Patients: An EUSTAR Analysis [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/changes-in-treatment-patterns-and-their-influence-on-the-outcome-of-systemic-sclerosis-interstitial-lung-disease-ssc-ild-patients-an-eustar-analysis/. Accessed .

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