ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1258

Upadacitinib in the treatment of Rheumatoid Arthritis – Interstitial Lung Disease. National multicenter study of 25 patients in clinical practice.

Ana Serrano-Combarro1, Belén Atienza-mateo2, Leticia del Olmo Perez3, Sara García-Perez4, Guillermo Gonzalez Mozo de Rosales5, Jose Rosas Gómez de Salazar6, ana Urruticoechea-Arana7, Andrea García-Valle8, Jesús Loarce9, Paula García-Escudero10, Bryan Josué Flores Robles11, Rafael B. Melero-González12, Alicia Garcia13, Maria Martín López14, Patricia López Viejo15, Maria Jose Perez Gaan16, Nuria Vegas Revenga17, Angel Garcia-Aparicio18, M.Pilar Bernabeu Gonzalvez19, Juan Moreno Morales20 and Ricardo Blanco21, 1Division of Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, Inmunopathology group, Santander, Santander, Spain, 2Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Immunopathology Group, Santander , Spain, PALMA DE MALLORCA/BALEARES, Spain, 3HGU Nuestra Señora del Prado, Talavera de la Reina, Talavera de la Reina, Spain, 4Complejo Hospitalario de Vigo, Vigo, Spain, 5Basurto University Hospital, Bilbao, Spain, 6Hospital Marina Baixa, PALMA DE MALLORCA, Spain, 7Rheumatology Division. Hospital Universitario Son Espases, Palma de Mallorca, Spain, 8Rheumatology. Hospital General Río Carrión, Palencia, Castilla y Leon, Spain, 9Ramón y Cajal University Hospital, Madrid, Spain, 10Hospital Universitario Álava, Bilbao, Spain, 11Hospital San Pedro, Logroño, Spain, 12COMPLEXO HOSPITALARIO UNIVERSITARIO DE OURENSE, O Carballino, Spain, 13Rheumatologist, La Laguna, Spain, 14Hospital 12 de Octubre, Madrid, Spain, 15Hospital Severo Ochoa (Leganés), Leganes, Spain, 16Hospital Universitario Virgen de las Nieves, Granada, Spain, 17Galdakao- Usansolo University Hospital, Galdakao, Spain, 18Hospital Universitario de Toledo, Toledo, Spain, 19Rheumatology Department, Dr. Balmis General University Hospital, Alicante, Spain., Alicante, Spain, 20Hospital Universitario Santa Lucia Cartagena, Cartagena, Spain, 21Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Immunopathology Group, Santander, Spain, Santander, Cantabria, Spain

Meeting: ACR Convergence 2025

Keywords: , , ,

Session Information

Date: Monday, October 27, 2025

Title: (2437–2469) Systemic Lupus Erythematosus – Treatment Poster III

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 usually the recommended drugs. JAK inhibitors (JAKi) have demonstrated efficacy in RA, especially tofacitinib and baricitinib. Nonetheless, evidence on eficacy efficacy of other JAKi like Upadacitinib (UPA) in RA-ILD is scarce. Our objective was to assess a) the effectiveness and b) the safety of UPA in RA-ILD patients.

Methods: National multicenter study of RA-ILD patients on treatment with UPA. We analyzed from baseline the following outcomes: a) forced vital capacity (FVC), b) diffusing capacity of the lungs for carbon monoxide (DLCO), c) high resolution computed tomography (HRCT), d) dyspnea (modified Medical Research Council scale), e) arthritis activity (DAS28-ESR), and f) sparing effect of glucocorticosteroids.

Results: We studied 25 patients (16 women/9 men; mean age 61±9 years) from clinical practice on treatment with UPA. Baseline demographic and clinical characteristics are shown in Table. All patients had received disease-modifying antirheumatic drugs (DMARDs) before UPA [conventional DMARDs (n=23; 92%), anti-TNF (12; 48%), Tocilizumab (7;28%), Abatacept (11; 44%) and Rituximab (4;18%)]. Mean baseline values of FVC and DLCO (% predicted) were 88±16, and 68±23, respectively. Patients were followed-up for a median [IQR] of 12 [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 [12 (67%)] showed articular remission or low activity. UPA was withdrawn in 5 (20%) patients due to ischemic heart disease (n=2), recurrent respiratory infections (n=1), zoster virus infection (n=1) and joint activity (n=1).

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

Supporting image 1Table. Baseline characteristics of RA-ILD patients treated with UPA.

Supporting image 2Figure. 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; L. del Olmo Perez: None; S. García-Perez: None; G. Gonzalez Mozo de Rosales: None; J. Rosas Gómez de Salazar: None; a. Urruticoechea-Arana: None; A. García-Valle: None; J. Loarce: None; P. García-Escudero: None; B. Flores Robles: None; R. Melero-González: None; A. Garcia: None; M. Martín López: None; P. López Viejo: None; M. Perez Gaan: None; N. Vegas Revenga: None; A. Garcia-Aparicio: AbbVie/Abbott, 6, AstraZeneca, 6, GlaxoSmithKlein(GSK), 1, 2, 6, UCB, 6; M. Bernabeu Gonzalvez: None; J. Moreno Morales: None; R. Blanco: AbbVie/Abbott, 2, 5, 6, Bristol-Myers Squibb(BMS), 2, 6, Eli Lilly, 2, 6, Janssen, 2, 6, Merck/MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6.

To cite this abstract in AMA style:

Serrano-Combarro A, Atienza-mateo B, del Olmo Perez L, García-Perez S, Gonzalez Mozo de Rosales G, Rosas Gómez de Salazar J, Urruticoechea-Arana a, García-Valle A, Loarce J, García-Escudero P, Flores Robles B, Melero-González R, Garcia A, Martín López M, López Viejo P, Perez Gaan M, Vegas Revenga N, Garcia-Aparicio A, Bernabeu Gonzalvez M, Moreno Morales J, Blanco R. Upadacitinib in the treatment of Rheumatoid Arthritis – Interstitial Lung Disease. National multicenter study of 25 patients in clinical practice. [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/upadacitinib-treatment-rheumatoid-arthritis-interstitial-lung-disease-national-multicenter-study-25-patients-clinical-practice/. Accessed .

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