Window of Opportunity in the Treatment of Rheumatoid Arthritis-Interstitial Lung Disease with Abatacept. National Multicenter Study of 509 Patients

Ana Serrano-Combarro¹, Belén Atienza-Mateo², libe Ibarrola-Paino³, Ivette Casafont-Sole⁴, Rafael Benito Melero-Gonzalez⁵, Alba Perez Linaza⁶, Santos Castañeda⁷, Rafaela Ortega Castro⁸, Natalia Mena Vazquez⁹, Nuria Vegas Revenga¹⁰, Lucia Cristina Dominguez Casas¹¹, Cilia Peralta¹², Trinidad Pérez-Sandoval¹³, Lorena Perez-Albadalejo¹⁴, Ruben Lopez-Sanchez¹⁵, MARIA GUADALUPE MANZANO CANABAL¹⁶, Anahy Maria Brandy-Garcia¹⁷, Patricia Lopez-Viejo¹⁸, Gema Bonilla¹⁹, Olga Maiz-Alonso²⁰, Carmen carrasco-Cubero²¹, Marta Garijo Bufort²², Mireia Moreno²³, Ana Urruticoechea²⁴, Sergio Ordonez-Palau²⁵, Carmen Gonzalez-Montagut Gomez²⁶, andrea Garcia-Valle²⁷, Juan Ramon De Dios Jimenez De Aber²⁸, Fernando Lozano²⁹, Tomás Vazquez-Rodriguez³⁰, Maria Martin-Lopez³¹, Juan Maria Blanco-Madrigal³², Delia Fernández-Lozano³³, Ignacio Brana Abascal³⁴, Jesus Loarce-Martos³⁵, Emilio Giner-Serret³⁶, Virginia Ruiz-Esquide³⁷, Clara ventin-Rodriguez³⁸, Marina Rodriguez-lopez³⁹, Pablo Andujar-Brazal⁴⁰, Julia Fernandez-Melon⁴¹, Lilian Maria Lopez⁴², carlos Fernandez-Diaz⁴³, Javier Loricera⁴⁴, Ivan Ferraz Amaro⁴⁵, Diego Ferrer⁴⁶, Ricardo Blanco⁴⁷ and On behalf of the Collaborative Group Members⁴⁸, ¹Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain, ²Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, ³Hospital Universitario de Navarra, Pamplona, Spain, ⁴Hospital Universitari Germans Trias i Pujol, Badalona, Spain, ⁵CHU Vigo, O Carballino, Spain, ⁶SERV. REUMATOLOGIA, Cadiz, Spain, ⁷Hospital Universitario de la Princesa, Madrid, Spain, ⁸Hospital Reina Sofía, Cordoba, Spain, ⁹IBIMA, Málaga, Spain, ¹⁰Hospital Galdakao- Usansolo, Galdakao, Spain, ¹¹Hospital Universtario San Agustin, Oviedo, Spain, ¹²Hospital Clínico Lozano Blesa, Zaragoza, Spain, ¹³Hospital de León, León, Spain, ¹⁴Division of Rheumatology, Hospital Universitario de Jaén, Jaén, Spain, ¹⁵Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain, ¹⁶CAZA, Salamanca, Spain, ¹⁷Hospital Germans Trias i Pujol, Badalona, Spain, ¹⁸Division of Rheumatology, Hospital Severo Ochoa, Leganéz, Spain, ¹⁹Department of Rheumatology, Hospital Clínico Universitario La Paz, Madrid, Spain, ²⁰University Hospital Donostia, San Sebastian, Spain, ²¹Department of Rheumatology, Hospital Universitario de Badajoz, Badajoz, Spain, ²²Hospital de Sagunto, Valencia, Spain, ²³Parc Tauli Hospital Universitari, I3PT(UAB), Barcelona, Spain, ²⁴Hospital Can Misses, Ibiza, Spain, ²⁵H. Arnau de Vilanova, Lleida, Spain, ²⁶H. Clínico Universitario de Valladolid, Valladolid, Spain, ²⁷Division of Rheumatology, Complejo Asistencial Universitario de Palencia, Palencia, Spain, ²⁸Hospital de Araba, Alava, Spain, ²⁹Hospital Universitario 12 de Octubre, Madrid, Spain, ³⁰Rheumatology, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain, ³¹Hospital 12 de Octubre, Madrid, Spain, ³²Division of Rheumatology, H. Universitario de Basurto, Bilbao, Spain, ³³Hospital de Mérida, Merida, Spain, ³⁴Division of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain, ³⁵Ramón y Cajal University Hospital, Madrid, Spain, ³⁶Hospital Royo Villanova, Teruel, Spain, ³⁷Hospital Clinic, Rheumatology, Barcelona, Spain, ³⁸Division of Rheumatology, Hospital Universitario de A Coruña, A Coruña, Spain, ³⁹Division of Rheumatology, Hospital Clínico Universitario de Santiago, La Coruna, Spain, ⁴⁰Division of Rheumatology, Hospital Universitario Doctor Peset, Valencia, Spain, ⁴¹Division of Rheumatology, Hospital Universitario Son Espases, Palma de Mallorca, Spain, ⁴²Division of Rheumatology, Hospital Universitario Son Llàtzer, Mallorca, Spain, ⁴³Division of Rheumatology, Hospital Universitario Reina Sofía, Murcia, Spain, ⁴⁴Hospital Universitario Marqués de Valdecilla, Santander, Spain, ⁴⁵Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain, ⁴⁶Division of Pneumology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, ⁴⁷Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, ⁴⁸Spanish Collaborative Group of Interstitial Lung Disease Associated with Rheumatoid Arthritis, Spain, Spain

Meeting: ACR Convergence 2023

Keywords: Disease-Modifying Antirheumatic Drugs (Dmards), interstitial lung disease, pulmonary, rheumatoid arthritis

Session Information

Date: Tuesday, November 14, 2023

Title: (2141–2176) RA – Treatments Poster III

Session Type: Poster Session C

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

Background/Purpose: Interstitial lung disease (ILD) is a severe complication of rheumatoid arthritis (RA). Abatacept (ABA) has demonstrated efficacy in the treatment of RA-ILD, especially if it is initiated early during the ILD. Our objective was to compare the efficacy of ABA in RA-ILD patients according to ILD duration.

Methods: National multicenter study of 509RA-ILD patients treated with ABA. Patients with ABA initiation early in the disease (during the first 6 months since ILD diagnosis) were compared to those in whom ABA was started after 2 years of ILD diagnosis (“early” vs. “late” group, respectively). We analyzed in the 2 groups 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), and e) arthritis activity (DAS28-ESR or clinical records).

Results: A total of 216 patients were included in the “early” group and 165 patients in the “late” group. Baseline demographic and clinical characteristics are shown in Table 1. Mean baseline values of FVC were significantly higher in the “early” group. The evolution of FVC and DLCO for 48 months is shown in Figure 1. Both parameters remained stable during 48 months of ABA therapy, with statistically significant differences found in case of FVC (although lower stable values of FVC in the “late” group). Available chest HRCT images improved/ stabilized in 76% and 54% of patients in the “early” and “late” group, respectively. Stabilization or improvement of dyspnea was found in most patients of both groups.

Conclusion: Our study suggests a window of opportunity for the treatment of RA-ILD patients with ABA. However, treatment with ABA at any time of the course in the ILD seems to prevent interstitial lung progression.

Table 1. Main general features at baseline of RA-ILD patients with “early” vs. “late” initiation of ABA in ILD course.

Figure 1. Evolution of pulmonary function tests in RA-ILD patients with “early” and “late” initiation of ABA in ILD course. FVC and DLCO are expressed as mean (95%CI) and compared between the 2 groups. (*) P value is statistically significant in FVC at baseline, 24, 36 and 48 months of follow up.

Disclosures: A. Serrano-Combarro: None; B. Atienza-Mateo: None; l. Ibarrola-Paino: None; I. Casafont-Sole: None; R. Melero-Gonzalez: None; A. Perez Linaza: None; S. Castañeda: None; R. Ortega Castro: None; N. Mena Vazquez: None; N. Vegas Revenga: None; L. Dominguez Casas: None; C. Peralta: None; T. Pérez-Sandoval: None; L. Perez-Albadalejo: None; R. Lopez-Sanchez: None; M. MANZANO CANABAL: None; A. Brandy-Garcia: None; P. Lopez-Viejo: None; G. Bonilla: None; O. Maiz-Alonso: None; C. carrasco-Cubero: None; M. Garijo Bufort: None; M. Moreno: None; A. Urruticoechea: None; S. Ordonez-Palau: None; C. Gonzalez-Montagut Gomez: None; a. Garcia-Valle: None; J. Dios Jimenez De Aber: None; F. Lozano: None; T. Vazquez-Rodriguez: None; M. Martin-Lopez: None; J. Blanco-Madrigal: None; D. Fernández-Lozano: None; I. Brana Abascal: None; J. Loarce-Martos: Boehringer-Ingelheim, 6, Bristol-Myers Squibb(BMS), 6, Galapagos, 6; E. Giner-Serret: None; V. Ruiz-Esquide: None; C. ventin-Rodriguez: None; M. Rodriguez-lopez: None; P. Andujar-Brazal: None; J. Fernandez-Melon: None; L. Lopez: None; c. Fernandez-Diaz: None; J. Loricera: None; I. Ferraz Amaro: AbbVie/Abbott, 5, 6, Amgen, 5, 6, Bristol-Myers Squibb(BMS), 6; D. Ferrer: None; R. Blanco: AbbVie, 5, 6, Amgen, 6, AstraZeneca, 2, BMS, 6, Eli Lilly, 6, Galapagos, 2, 6, Janssen, 2, 6, MSD, 6, Novartis, 2, 6, Pfizer, 2, 6, Roche, 5, 6, Sanofi, 6; O. Collaborative Group Members: None.

To cite this abstract in AMA style:

Serrano-Combarro A, Atienza-Mateo B, Ibarrola-Paino l, Casafont-Sole I, Melero-Gonzalez R, Perez Linaza A, Castañeda S, Ortega Castro R, Mena Vazquez N, Vegas Revenga N, Dominguez Casas L, Peralta C, Pérez-Sandoval T, Perez-Albadalejo L, Lopez-Sanchez R, MANZANO CANABAL M, Brandy-Garcia A, Lopez-Viejo P, Bonilla G, Maiz-Alonso O, carrasco-Cubero C, Garijo Bufort M, Moreno M, Urruticoechea A, Ordonez-Palau S, Gonzalez-Montagut Gomez C, Garcia-Valle a, Dios Jimenez De Aber J, Lozano F, Vazquez-Rodriguez T, Martin-Lopez M, Blanco-Madrigal J, Fernández-Lozano D, Brana Abascal I, Loarce-Martos J, Giner-Serret E, Ruiz-Esquide V, ventin-Rodriguez C, Rodriguez-lopez M, Andujar-Brazal P, Fernandez-Melon J, Lopez L, Fernandez-Diaz c, Loricera J, Ferraz Amaro I, Ferrer D, Blanco R, Collaborative Group Members O. Window of Opportunity in the Treatment of Rheumatoid Arthritis-Interstitial Lung Disease with Abatacept. National Multicenter Study of 509 Patients [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/window-of-opportunity-in-the-treatment-of-rheumatoid-arthritis-interstitial-lung-disease-with-abatacept-national-multicenter-study-of-509-patients/. Accessed .

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