Rheumatoid Arthritis - Progressive Interstitial Lung Disease with Abatacept: Data from a Large National Multicenter Cohort

Ana Serrano-Combarro¹, Belén Atienza-Mateo², Libe Ibarrola Paino³, Ivette Casafont-Sole⁴, Jesús Loarce⁵, Juan María Blanco Madrigal⁶, Santos Castañeda⁷, Rafaela Ortega-Castro⁸, Natalia Mena Vázquez⁹, Nuria Vegas Revenga¹⁰, Lucia Cristina Dominguez Casas¹¹, Cilia Peralta Ginés¹², Carolina Diez Morrondo¹³, Lorena Pérez Albadalejo¹⁴, Rubén López Sánchez¹⁵, MARIA GUADALUPE MANZANO CANABAL¹⁶, Anahy Maria Brandy-Garcia¹⁷, Patricia Lopez Viejo¹⁸, Gema Bonilla¹⁹, Olga Maíz Alonso²⁰, Carmen Carrasco-Cubero²¹, Marta Garijo Bufort²², Mireia Moreno Martinez-Losa²³, Ana Urruticoechea-Arana²⁴, Sergi Ordoñez²⁵, Carmen González Montagut²⁶, Andrea García-Valle²⁷, Juan Ramón De Dios²⁸, Patricia Carreira²⁹, Tomás Vázquez Rodríguez³⁰, Delia Fernández-Lozano³¹, Ignacio Brana Abascal³², Rafael Benito Melero-Gonzalez³³, Emilio Giner³⁴, Virginia Ruiz Esquide³⁵, Clara Ventin Rodriguez³⁶, Marina Rodriguez³⁷, Pablo Andújar-Brazal³⁸, Julia Fernandez Melon³⁹, Lilian M. López-Núñez⁴⁰, JOSE RAMON LAMUA RIAZUELO⁴¹, Carlos Fernández Díaz⁴², Javier Loricera⁴³ and Ricardo Blanco-Alonso⁴⁴, ¹Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain, ²Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Cantabria, Spain, ³Rheumatology Division, Bisadoa Hospital, Bidasoa, Spain, ⁴Hospital Universitari Germans Trias i Pujol, Badalona, Spain, ⁵Ramón y Cajal University Hospital, Madrid, Madrid, Spain, ⁶Basurto University Hospital, Bilbao, Spain, ⁷Hospital Universitario de la Princesa, Madrid, Spain, ⁸Hospital Reina Sofía, Cordoba, Andalucia, Spain, ⁹IBIMA, Málaga, Andalucia, Spain, ¹⁰Hospital Galdakao- Usansolo, Galdakao, Spain, ¹¹Hospital Universtario San Agustin, Oviedo, Spain, ¹²Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, ¹³Hospital de Leon, León, Spain, ¹⁴Hospital Universitario de Jaén, Jaén, Spain, ¹⁵Hospital Universitario de Gran Canaria Dr. Negrín, Gran Canaria, Spain, ¹⁶CAZA, Salamanca, Spain, ¹⁷Hospital Germans Trias i Pujol, Badalona, Spain, ¹⁸Hospital Severo Ochoa, Madrid, Madrid, Spain, ¹⁹H. Universitario La Paz, Madrid, Spain, ²⁰3Hospital Universitario de Donosti, San Sebastian, Spain, San Sebastian, Pais Vasco, Spain, ²¹Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain, ²²Hospital de Sagunto, Valencia, Spain, ²³Parc Tauli Hospital Universitari, I3PT(UAB), Barcelona, Spain, ²⁴Hospital Son Espases, Palma de Mallorca, Islas Baleares, Spain, ²⁵Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain, ²⁶Hospital Universitario de Valladolid, Valladolid, Spain, ²⁷Hospital General Río Carrión, Palencia, Spain, ²⁸Osakidetza, Vitoria, Spain, ²⁹Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain, ³⁰Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain, ³¹Hospital Clínico Universitario de Valencia, Valencia, Spain, ³²Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain, ³³CHU Ourense, O Carballino, Spain, ³⁴Hospital Royo Villanova, Teruel, Spain, ³⁵Hospital Clinic Barcelona, Barcelona, Spain, ³⁶Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain, ³⁷Hospital Clínico Universitario de Santiago, La Coruna, Spain, ³⁸Hospital Universitario Doctor Peset, Valencia, Spain, ³⁹Hospital Son Espases, Palma, Spain, ⁴⁰Hospital Universitari Son Llàtzer, Palma, Spain, ⁴¹Hospital Universitario del Henares, Madrid, Spain, ⁴²Hospital Universitario Santa Lucía, Cartagena, Spain, ⁴³Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, ⁴⁴Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: autoimmune diseases, rheumatoid arthritis, Rheumatoid Factor

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 extra-articular manifestation of rheumatoid arthritis (RA). Abatacept (ABA) has demonstrated effectiveness in the treatment of RA-ILD, regardless combined or not with methotrexate and the radiological pattern. Although global results are satisfactory, there are patients who present progression of ILD despite its use. The characterization of this group of patients is crucial for its early identification and management. Our objective is to assess a) the RA-ILD patients treated with ABA with progression of ILD and b) comparative study with patients without progression.

Methods: From a large observational multicenter study of 526 RA-ILD patients treated with ABA, we selected those with available pulmonary function tests (PFTs) follow-up data. Progression of ILD was defined as an absolute decline of forced vital capacity (FVC) of ≥10% within 2 years of follow-up since ABA initiation (Figure). compared demographic and clinical variables of patients with ILD progression vs. patients with ILD improvement or stabilization. Results are expressed as percentage, mean±SD or median [IQR].

Results: We included a total of 343 patients with available data on FVC evolution, of which 80 (23.3%) presented ILD progression and 263 (76.7%) had a favorable lung function course. The differential baseline demographic and clinical characteristics between these 2 groups of patients are displayed in Table. We found no statistically significant differences between both groups in terms of age, sex, smoking, ILD duration up to ABA initiation, positivity of rheumatoid factor or anti-citrullinated protein autoantibodies, combined treatment, prednisone dose, baseline PFTs or radiological pattern. The differences in basal dyspnea and previous therapy with methotrexate and tocilizumab were statistically significant.

Conclusion: Almost a quarter of patients with ABA therapy presented ILD progression. There were few differences between progressive group and non-progressive group. Although ABA has consistently demonstrated effectiveness in the treatment of RA-ILD, its response should be closely monitored in all the patients to early detect progression.

Table. Comparison of main baseline features of RA-ILD patients treated with ABA divided into ILD progression and no-ILD progression groups.

Figure. Evolution of FVC in patients included in “ILD progression” group vs in those included in “no ILD progression” (progression of ILD was defined as an absolute decline of forced vital capacity (FVC) of ≥10% within 2 years of follow-up since ABA initiation). * p <0,05

Disclosures: A. Serrano-Combarro: None; B. Atienza-Mateo: None; L. Ibarrola Paino: None; I. Casafont-Sole: None; J. Loarce: None; J. Blanco Madrigal: 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; R. Ortega-Castro: None; N. Mena Vázquez: None; N. Vegas Revenga: None; L. Dominguez Casas: None; C. Peralta Ginés: None; C. Diez Morrondo: None; L. Pérez Albadalejo: None; R. López Sánchez: None; M. MANZANO CANABAL: None; A. Brandy-Garcia: None; P. Lopez Viejo: None; G. Bonilla: None; O. Maíz Alonso: None; C. Carrasco-Cubero: None; M. Garijo Bufort: None; M. Moreno Martinez-Losa: None; A. Urruticoechea-Arana: None; S. Ordoñez: None; C. González Montagut: None; A. García-Valle: None; J. De Dios: None; P. Carreira: None; T. Vázquez Rodríguez: None; D. Fernández-Lozano: None; I. Brana Abascal: None; R. Melero-Gonzalez: None; E. Giner: None; V. Ruiz Esquide: None; C. Ventin Rodriguez: None; M. Rodriguez: None; P. Andújar-Brazal: None; J. Fernandez Melon: None; L. López-Núñez: None; J. LAMUA RIAZUELO: None; C. Fernández Díaz: None; J. Loricera: AstraZeneca, 2, 6, Celgene, 2, 6, Eli Lilly, 5, Janssen, 5, Merck/MSD, 2, 5, 6, Novartis, 12, Formation/Congress attendance, Pfizer, 5, Roche, 2, 5, 6, UCB, 2, 5, 6; 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, Ibarrola Paino L, Casafont-Sole I, Loarce J, Blanco Madrigal J, Castañeda S, Ortega-Castro R, Mena Vázquez N, Vegas Revenga N, Dominguez Casas L, Peralta Ginés C, Diez Morrondo C, Pérez Albadalejo L, López Sánchez R, MANZANO CANABAL M, Brandy-Garcia A, Lopez Viejo P, Bonilla G, Maíz Alonso O, Carrasco-Cubero C, Garijo Bufort M, Moreno Martinez-Losa M, Urruticoechea-Arana A, Ordoñez S, González Montagut C, García-Valle A, De Dios J, Carreira P, Vázquez Rodríguez T, Fernández-Lozano D, Brana Abascal I, Melero-Gonzalez R, Giner E, Ruiz Esquide V, Ventin Rodriguez C, Rodriguez M, Andújar-Brazal P, Fernandez Melon J, López-Núñez L, LAMUA RIAZUELO J, Fernández Díaz C, Loricera J, Blanco-Alonso R. Rheumatoid Arthritis – Progressive Interstitial Lung Disease with Abatacept: Data from a Large National Multicenter Cohort [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/rheumatoid-arthritis-progressive-interstitial-lung-disease-with-abatacept-data-from-a-large-national-multicenter-cohort/. Accessed .

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