Date: Sunday, November 5, 2017
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).
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 February 29, 2020.
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