ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1372

Upadacitinib and Other JAK Inhibitors in the Treatment of Rheumatoid Arthritis – Interstitial Lung Disease. National Multicenter Study Clinical Practice.

Ana Serrano-Combarro1, Belén Atienza-Mateo2, Jesús Loarce3, Leticia del Olmo Perez4, Sara García-Pérez5, Guillermo Gonzalez Mozo de Rosales6, José Rosas-Gómez de Salazar7, Ana Urruticoechea-Arana8, Andrea García-Valle9, Juan Moreno Morales10, María Martín López11, Patricia Lopez Viejo12, Virginia Ruiz-Esquide13, Julia Fernandez Melon14, David Castro-Corredor15, Ana Fernández-Ortiz16, Rafael Benito Melero-Gonzalez17, Carolina Díez Morrondo18, Desiree Palma19, Natividad del Val del Amo20, Natalia Mena Vázquez21, Alicia García Dorta22, MARÍA JOSÉ PÉREZ GALÁN23, MARINA SOLEDAD MORENO GARCIA24 and Ricardo Blanco-Alonso25, and on behalf of JAKi in Interstitial Lung Disease Associated with Rheumatoid Arthritis, 1Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain, 2Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Cantabria, Spain, 3Ramón y Cajal University Hospital, Madrid, Madrid, Spain, 4HOSPITAL NUESTRA SEÑORA DEL PRADO, TALAVERA DE LA REINA, Spain, 5Complejo Hospitalario de Vigo, Vigo, Galicia, Spain, 6Basurto University Hospital, Bilbao, Spain, 7Hospital Marina Baixa, PALMA DE MALLORCA, Comunidad Valenciana, Spain, 8Hospital Son Espases, Palma de Mallorca, Islas Baleares, Spain, 9Hospital General Río Carrión, Palencia, Spain, 10Hospital Universitario Santa Lucia Cartagena, Murcia, Murcia, Spain, 11General University Hospital of Ciudad Real, Ciudad de México, Spain, 12Hospital Severo Ochoa, Madrid, Madrid, Spain, 13Hospital Clinic de Barcelona, Barcelona, Spain, 14Hospital Son Espases, Palma, Spain, 15General University Hospital of Ciudad Real, Santa Cruz de Mudela (Ciudad Real), Spain, 16Hospital Universitario de Badajoz, Badajoz, Spain, 17CHU Ourense, O Carballino, Spain, 18Complejo Asistencial Universitario de Leon, Leon, 19Hospital Rafael Méndez, Lorca, Murcia, Spain, 20Complejo Hospitalario de Navarra, Pamplona, Spain, 21IBIMA, Málaga, Andalucia, Spain, 22Rheumatologist, La Laguna, Spain, 23SERVICIO ANDALUZ DE SALUD, GRANADA, Andalucia, Spain, 24Hospital Universitario Miguel Servet, GIJON, Asturias, Spain, 25Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: ,

Session Information

Date: Sunday, November 17, 2024

Title: RA – Treatment Poster II

Session Type: Poster Session B

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

Background/Purpose: Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). Abatacept and rituximab are the recommended drugs. JAK inhibitors (JAKi) have demonstrated efficacy in RA. Nonetheless, evidence on efficacy of JAKi in RA-ILD is scarce. Our objective is to assess a) the effectiveness and b) the safety of Upadacitinib (UPA) and other JAKi in RA-ILD patients.

Methods: National multicenter study of RA-ILD patients on treatment with Upadacitinib (UPA), Filgotinib (FILGO) and Tofacitinib (TOFA). We analyzed from baseline the following outcomes: 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), and f) sparing corticosteroids effect.

Results: We studied 37 patients (25 women/ 12 men; mean age 65±10 years) from clinical practice on treatment with JAKi [UPA=18 (49%), FILGO= 9 (24%) and TOFA=10 (27%)]. Baseline demographic and clinical characteristics are shown in Table. All patients had received disease-modifying antirheumatic drugs (DMARDs) before JAKi [Conventional (n=37; 100%), anti-TNF (18; 49%), Tocilizumab (10; 29%), Abatacept (18; 51%), and Rituximab (7; 20%)]. Since most patients were on UPA we focused on this group (n=18). Mean baseline values of FVC and DLCO (% predicted) were 79±34 and 76±15, respectively. Patients were followed-up for a median [IQR] of 11 [6-18] months. The evolution of FVC and DLCO remained stable during the first 12 months (Figure). At the end of the follow-up, available chest HRCT images improved/stabilized in all the patients. Stabilization or improvement of dyspnea was found in all the patients. Most patients [10 (67%)] showed articular remission or low activity. UPA was withdrawn in 2 (11%) patients due to zoster virus infection (n=1) and ischemic heart disease (n=1).

Conclusion: JAKi, in this series UPA, may be useful and safe in controlling the course of both pulmonary and joint disease in RA-ILD patients, even in refractory cases to ABA and/or RTX. More studies are needed.

Supporting image 1

Table. Baseline characteristics of RA-ILD patients treated with UPA, TOFA and FILGO.

Supporting image 2

Figure. Evolution of pulmonary function tests (mean % of the predicted FVC and DLCO) in RA-ILD patients with UPA therapy at baseline and 12 months.

Disclosures: A. Serrano-Combarro: None; B. Atienza-Mateo: None; J. Loarce: None; L. del Olmo Perez: None; S. García-Pérez: None; G. Gonzalez Mozo de Rosales: None; J. Rosas-Gómez de Salazar: None; A. Urruticoechea-Arana: None; A. García-Valle: None; J. Moreno Morales: None; M. Martín López: None; P. Lopez Viejo: None; V. Ruiz-Esquide: None; J. Fernandez Melon: None; D. Castro-Corredor: None; A. Fernández-Ortiz: None; R. Melero-Gonzalez: None; C. Díez Morrondo: None; D. Palma: None; N. del Val del Amo: None; N. Mena Vázquez: None; A. García Dorta: None; M. PÉREZ GALÁN: None; M. MORENO GARCIA: 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, Loarce J, del Olmo Perez L, García-Pérez S, Gonzalez Mozo de Rosales G, Rosas-Gómez de Salazar J, Urruticoechea-Arana A, García-Valle A, Moreno Morales J, Martín López M, Lopez Viejo P, Ruiz-Esquide V, Fernandez Melon J, Castro-Corredor D, Fernández-Ortiz A, Melero-Gonzalez R, Díez Morrondo C, Palma D, del Val del Amo N, Mena Vázquez N, García Dorta A, PÉREZ GALÁN M, MORENO GARCIA M, Blanco-Alonso R. Upadacitinib and Other JAK Inhibitors in the Treatment of Rheumatoid Arthritis – Interstitial Lung Disease. National Multicenter Study Clinical Practice. [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/upadacitinib-and-other-jak-inhibitors-in-the-treatment-of-rheumatoid-arthritis-interstitial-lung-disease-national-multicenter-study-clinical-practice/. Accessed .

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