Response to Abatacept of Different Patterns of Interstitial Lung Disease in Rheumatoid Arthritis. Multicenter Study of 63 Patients

Carlos Fernández-Díaz¹, Santos Castañeda², Clara Ojeda-Garcia³, Alejandro Olivé⁴, Patricia Carreira⁵, Trinidad Perez Sandoval⁶, Miriam Retuerto Guerrero⁷, Evelin Cecilia Cervantes Pérez⁸, Samantha Rodriguez⁹, Bryan Josue Robles Flores¹⁰, Blanca Hernández-Cruz¹¹, Ana Urruticoechea-Arana¹², Olga Maiz¹³, Desiree Palma¹⁴, Luis Arboleya¹⁵, Gema Bonilla¹⁶, Manuel Rodríguez-Gómez¹⁷, Concepción Delgado¹⁸, Rosa Expósito¹⁹, Ana Ruibal Escribano²⁰, Juan Blanco Madrigal²¹, José Antonio Bernal²², Paloma Vela²³, Belen Alvarez-Rodriguez²⁴, María Concepción Fito Manteca²⁵, Javier Narváez²⁶, Manuel Jose Moreno²⁷, Mireia López-Corbeto²⁸, Natalia Mena-Vazquez²⁹, S. Romero-Yuste³⁰, Clara Aguilera-Cros³¹, Sergi Ordoñez³², Ignacio Villa-Blanco³³, Nuria Vegas-Revenga¹, Victor Mora-Cuesta³⁴, Javier Loricera¹, Miguel Angel González-Gay¹, José Luis Hernandez³⁵ and Ricardo Blanco¹, ¹Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, ²Hospital Universitario de La Princesa, Madrid. Spain, Madrid, Spain, ³Rheumatology, Hospital Virgen de la Macarena, Sevilla, Spain, ⁴Rheumatology, Hospital Germans Trias i Pujol, Badalona, Spain, ⁵Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain, ⁶Rheumatology, Hospital de León, LEÓN, Spain, ⁷Rheumatology, Hospital de León, Leon, Spain, ⁸Rheumatology, Hospital Santiago de Compostela, Santiago de Compostela, Spain, ⁹H. German Trias., Barcelona, Spain, ¹⁰Rheumatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain, ¹¹Rheumatology, Hospital Universitario Virgen Macarena, Sevilla, Spain, ¹²Rheumatology Department. Hospital Can Misses, IBIZA, Spain, ¹³Hospital Donostia. Spain, San Sebastian, Spain, ¹⁴Rheumatology, Rafael Mendez Hospital, Spain., Lorca (Murcia), Spain, ¹⁵Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain, ¹⁶Hospital Universitario La Paz, Madrid, Spain, ¹⁷Complejo Hospitalario Universitario de Ourense, Ourense, Spain, ¹⁸H. Clínico Universitario Lozano Blesa, Zaragoza, Spain, ¹⁹Rheumatology, Hospital Comarcal de Laredo. Spain, Laredo, Spain, ²⁰Rheumatology, Hospital Universitario de Araba, Vittoria, Spain, ²¹Rheumatology, Hospital de Basurto, BIlbao, Spain, ²²Reumatología, Hospital Universitario del Vinalopó, Elche, Spain, ²³Reumatología, Hospital General Universitario de Alicante. Alicante. Spain, Alicante, Spain, ²⁴Hospital Txagorritxu, Vittoria, Spain, ²⁵Reumatología, Hospital de Navarra, Pamplona, Spain, ²⁶Rheumatology Department, Hospital de Bellvitge. Barcelona. Spain, L’Hospitalet de Llobregat, Spain, ²⁷Rheumatology, Hospital Virgen de la Arrixaca, MURCIA, Spain, ²⁸Hospital Universitario Vall d´Hebron, Barcelona, Spain, ²⁹Rheumatology, Hospital Universitario de Malaga, Malaga, Spain, ³⁰H. Pontevedra, Pontevedra, Spain, ³¹Rheumatology, Hospital Virgen del Rocio, Sevilla, Spain, ³²Hospital Universitario Arnau de Vilanova, Vilanova, Spain, ³³Hospital de Sierrallana, Sierrallana, Spain, ³⁴Neumology, Hospital Universitario Marqués de Valdecilla, IDIVAL,, Santander, Spain, ³⁵Division of Internal Medicine., Hospital Universitario Marqués de Valdecilla, IDIVAL,, Santander, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Abatacept, interstitial lung disease and rheumatoid arthritis, treatment

Session Information

Date: Sunday, November 5, 2017

Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy Poster I: Comorbidities and Adverse Events; Efficacy and Safety of Small Molecules

Session Type: ACR Poster Session A

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

Background/Purpose: Disease modifying antirheumatic drugs (DMARD) such as methotrexate (MTX), ) or antiTNFα have been implicated in exacerbation of Interstitial lung disease (ILD)of rheumatoid arthritis (RA). Several radiological patterns of ILD have been described: i) usual interstitial pneumonia (UIP), ii) nonspecific interstitial pneumonia (NSIP), iii) obliterating bronchitis (OB), and iv) Organized pneumonia (OP)

Our aime was to assess the response to Abatacept (ABA) in these patterns of ILD

Methods: Retrospective multicenter study of RA-ILD treated with ABA. ILD was diagnosed by high-resolution CT scan (HRCT) and classified in radiological patterns (Travis et al). We consider 3 subgroups: a) UIP, b) NSIP and c) "other" (OB, OP or mixed). ABA was used at standard dose. We assessed: a) Dyspnea (Medical Research Council-modified scale; significant variations≥1); B) Respiratory function tests; significant changes≥10% in forced vital capacity (FVC) and DLCO≤10%, c) HRCT, d) DAS28. A comparative study was performed for the qualitative variables (Fisher test) between the baseline and 3, 6 and 12 months

Results: We included 63 patients 29 UIP 17 NSIP 17 Others (27 women/36 men), mean age; 63.1±9.6 years. Patients with RA was seropositive in 85.7%. The ILD was related to DMARDs: MTX (4), etanercept (3), adalimumab (3), certolizumab (2), Infliximab (1). ABA was used in monotherapy (26) or combined with other DMARDs (37); LFN (15), Cyclosporin (1), sulfasalazine (4), MTX (6), hydroxychloroquine (10), azathioprine (4), chloroquine (1). Figure shows the evolution in the available cases. A significant improvement in dyspnea and HRCT. DLCO remained stable in most patients regardless of the radiological pattern. The activity of RA (DAS28) also improved.

Figure a), b) c): Evolution of different ILD patterns.

Conclusion: ABA appears to be effective in ILD associated-RA, including the pattern of poor prognosis (UIP).

Disclosure: C. Fernández-Díaz, None; S. Castañeda, None; C. Ojeda-Garcia, None; A. Olivé, None; P. Carreira, None; T. Perez Sandoval, None; M. Retuerto Guerrero, None; E. C. Cervantes Pérez, None; S. Rodriguez, None; B. J. Robles Flores, None; B. Hernández-Cruz, None; A. Urruticoechea-Arana, None; O. Maiz, None; D. Palma, None; L. Arboleya, None; G. Bonilla, None; M. Rodríguez-Gómez, None; C. Delgado, None; R. Expósito, None; A. Ruibal Escribano, None; J. Blanco Madrigal, None; J. A. Bernal, None; P. Vela, None; B. Alvarez-Rodriguez, None; M. C. Fito Manteca, None; J. Narváez, None; M. J. Moreno, None; M. López-Corbeto, None; N. Mena-Vazquez, None; S. Romero-Yuste, None; C. Aguilera-Cros, None; S. Ordoñez, None; I. Villa-Blanco, None; N. Vegas-Revenga, None; V. Mora-Cuesta, None; J. Loricera, None; M. A. González-Gay, None; J. L. Hernandez, None; R. Blanco, None.

To cite this abstract in AMA style:

Fernández-Díaz C, Castañeda S, Ojeda-Garcia C, Olivé A, Carreira P, Perez Sandoval T, Retuerto Guerrero M, Cervantes Pérez EC, Rodriguez S, Robles Flores BJ, Hernández-Cruz B, Urruticoechea-Arana A, Maiz O, Palma D, Arboleya L, Bonilla G, Rodríguez-Gómez M, Delgado C, Expósito R, Ruibal Escribano A, Blanco Madrigal J, Bernal JA, Vela P, Alvarez-Rodriguez B, Fito Manteca MC, Narváez J, Moreno MJ, López-Corbeto M, Mena-Vazquez N, Romero-Yuste S, Aguilera-Cros C, Ordoñez S, Villa-Blanco I, Vegas-Revenga N, Mora-Cuesta V, Loricera J, González-Gay MA, Hernandez JL, Blanco R. Response to Abatacept of Different Patterns of Interstitial Lung Disease in Rheumatoid Arthritis. Multicenter Study of 63 Patients [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/response-to-abatacept-of-different-patterns-of-interstitial-lung-disease-in-rheumatoid-arthritis-multicenter-study-of-63-patients/. Accessed .

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