Window of Opportunity in the Treatment of Rheumatoid Arthritis - Interstitial Lung Disease with Abatacept. National Multicenter Study of 526 Patients

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, Lucía Domínguez Casas¹¹, Cilia Peralta Ginés¹², Miriam Retuerto Guerrero¹³, 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, Ana Urruticoechea Arana²³, Sergi Ordoñez²⁴, Carmen González Montagut²⁵, Andrea García-Valle²⁶, Juan Ramón De Dios²⁷, María Martín López²⁸, Tomás Vázquez Rodríguez²⁹, Delia Fernández-Lozano³⁰, Ignacio Brana Abascal³¹, Rafael Benito Melero-Gonzalez³², Emilio Giner³³, Virginia Ruiz-Esquide³⁴, Clara Ventin Rodriguez³⁵, Marina Rodriguez³⁶, Pablo Andújar-Brazal³⁷, Julia Fernandez Melon²³, Lilian M. López-Núñez³⁸, JOSE RAMON LAMUA RIAZUELO³⁹, Anna Pamies Corts⁴⁰, Carlos Fernández Díaz⁴¹, Javier Loricera⁴², Diego Ferrer⁴³ 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 Universitario San Agustín, Avilés, Spain, ¹²Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, ¹³Complejo Asistencial Universitario de León, Leon, 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, ²⁰Hospital Universitario de Donosti, Donosti, Spain, ²¹Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain, ²²Hospital de Sagunto, Valencia, Spain, ²³Hospital Son Espases, Palma, Spain, ²⁴Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain, ²⁵Hospital Universitario de Valladolid, Valladolid, Spain, ²⁶Hospital General Río Carrión, Palencia, Spain, ²⁷Osakidetza, Vitoria, Spain, ²⁸General University Hospital of Ciudad Real, Ciudad de México, Spain, ²⁹Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain, ³⁰Hospital Clínico Universitario de Valencia, Valencia, Spain, ³¹Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain, ³²CHU Ourense, O Carballino, Spain, ³³Hospital Royo Villanova, Teruel, Spain, ³⁴Hospital Clinic de Barcelona, Barcelona, Spain, ³⁵Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain, ³⁶Hospital Clínico Universitario de Santiago, La Coruna, Spain, ³⁷Hospital Universitario Doctor Peset, Valencia, Spain, ³⁸Hospital Universitari Son Llàtzer, Palma, Spain, ³⁹Hospital Universitario del Henares, Madrid, Spain, ⁴⁰Hospital Verge de la Cinta, Tortosa, TARRAGONA, Spain, ⁴¹Hospital Universitario Santa Lucía, Cartagena, Spain, ⁴²Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, ⁴³Division of Pneumology, Hospital Universitario Marqués de Valdecilla, Santander, Spain, ⁴⁴Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: rheumatoid arthritis

Session Information

Date: Monday, November 18, 2024

Title: RA – Treatment Poster III

Session Type: Poster Session C

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

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. Our objective is to compare the efficacy of ABA in RA-ILD patients according to ILD duration.

Methods: National multicenter study of 526 RA-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 223 patients were included in the “early” group and 170 patients in the “late” group. Baseline demographic and clinical characteristics are shown in Table. 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. 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 74% and 57% of patients in the “early” and “late” group, respectively. Stabilization or improvement of dyspnea was found in most patients of both groups.

Conclusion: Treatment with ABA at any time of the course in the ILD seems to prevent interstitial lung progression. However, our results suggest that the same treatment (ABA) prescribed early in RA-ILD, may be preferable to preserve lung function (“window of opportunity”).

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

Figure. 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 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; 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. Domínguez Casas: None; C. Peralta Ginés: None; M. Retuerto Guerrero: 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; A. Urruticoechea Arana: None; S. Ordoñez: None; C. González Montagut: None; A. García-Valle: None; J. De Dios: None; M. Martín López: 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; A. Pamies Corts: 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; D. Ferrer: 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, Ibarrola Paino L, Casafont-Sole I, Loarce J, Blanco Madrigal J, Castañeda S, Ortega-Castro R, Mena Vázquez N, Vegas Revenga N, Domínguez Casas L, Peralta Ginés C, Retuerto Guerrero M, 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, Urruticoechea Arana A, Ordoñez S, González Montagut C, García-Valle A, De Dios J, Martín López M, 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, Pamies Corts A, Fernández Díaz C, Loricera J, Ferrer D, Blanco-Alonso R. Window of Opportunity in the Treatment of Rheumatoid Arthritis – Interstitial Lung Disease with Abatacept. National Multicenter Study of 526 Patients [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/window-of-opportunity-in-the-treatment-of-rheumatoid-arthritis-interstitial-lung-disease-with-abatacept-national-multicenter-study-of-526-patients/. Accessed .

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