1. Abatacept in interstitial lung disease associated with rheumatoid arthritis: national multicenter study of 263 patients
- Author
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Paloma Vela Casasempere, Santos Castañeda, Juan R D Jiménez de Aberásturi, A. Urruticoechea-Arana, Clara Aguilera-Cros, Francisco Ortiz-Sanjuán, Ruben López-Sánchez, Iñigo Hernández Rodríguez, Susana Romero-Yuste, Neus Quillis-Marti, Antonio Juan-Mas, J. M. Blanco-Madrigal, A. Ruibal-Escribano, José Antonio Bernal-Vidal, Julia Fernández-Melón, Jesús C Fernández-López, María C Fito, José L. Hernández, Raul Castellanos-Moreira, F Javier Narváez García, Natalia Mena-Vázquez, Carmen Carrasco-Cubero, Cilia Peralta-Ginés, José L. Andreu, Samantha Rodríguez-Muguruza, Evelin C Cervantes Pérez, Ivette Casafont-Solé, Pilar Morales-Garrido, María Gema Bonilla Hernán, Cristina Hidalgo-Calleja, Sebastián C Rodríguez-García, Iván Cabezas-Rodríguez, Sonia Castro-Oreiro, C. Ojeda-Garcia, Raquel Almodóvar-González, Manuel J Moreno-Ramos, C. Fernández-Díaz, Blanca Garcia-Magallon, A. García-Valle, Eva Salgado-Pérez, Rosa Expósito-Molinero, Carmen González-Montagut, Ana María López-Robles, O. Maiz-Alonso, Trinidad Pérez-Sandoval, Rafael Benito Melero-González, Lorena Pérez-Albadalejo, Natividad del Val del Amo, Javier Loricera-García, Miguel A. González-Gay, Ángel García-Aparicio, Luis Arboleya-Rodríguez, Ricardo Blanco, Iván Castellvi-Barranco, Erique Raya-Alvarez, Lorena Expósito-Pérez, Mireia López-Corbeto, Sergio Ordóñez-Palau, Isabel Serrano-García, Alejandro Olivé, Sabela Fernández-Aguado, Manuel Rodríguez-Gómez, Patricia Carreira-Delgado, Deseada Palma-Sánchez, María N Alvarez-Rivas, and Ignacio Villa
- Subjects
Male ,rheumatoid arthritis ,musculoskeletal diseases ,Vital capacity ,medicine.medical_specialty ,High-resolution computed tomography ,abatacept ,interstitial lung disease ,high-resolution computed tomography ,Gastroenterology ,behavioral disciplines and activities ,Abatacept ,Arthritis, Rheumatoid ,FEV1/FVC ratio ,Rheumatology ,Usual interstitial pneumonia ,Interquartile range ,DLCO ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Lung volumes ,medicine.diagnostic_test ,business.industry ,Interstitial lung disease ,respiratory system ,medicine.disease ,abatacept, high-resolution computed tomography, interstitial lung disease, rheumatoid arthritis ,respiratory tract diseases ,body regions ,Treatment Outcome ,Antirheumatic Agents ,Female ,Lung Diseases, Interstitial ,Tomography, X-Ray Computed ,business - Abstract
Objective To assess the efficacy of abatacept (ABA) in RA patients with interstitial lung disease (ILD) (RA-ILD). Methods This was an observational, multicentre study of RA-ILD patients treated with at least one dose of ABA. ILD was diagnosed by high-resolution CT (HRCT). We analysed the following variables at baseline (ABA initiation), 12 months and at the end of the follow-up: Modified Medical Research Council (MMRC) scale (1-point change), forced vital capacity (FVC) or diffusion lung capacity for carbon monoxide (DLCO) (improvement or worsening ≥10%), HRCT, DAS on 28 joints evaluated using the ESR (DAS28ESR) and CS-sparing effect. Results We studied 263 RA-ILD patients [150 women/113 men; mean (s.d.) age 64.6 (10) years]. At baseline, they had a median duration of ILD of 1 (interquartile range 0.25–3.44) years, moderate or severe degree of dyspnoea (MMRC grade 2, 3 or 4) (40.3%), FVC (% of the predicted) mean (s.d.) 85.9 (21.8)%, DLCO (% of the predicted) 65.7 (18.3) and DAS28ESR 4.5 (1.5). The ILD patterns were: usual interstitial pneumonia (UIP) (40.3%), non-specific interstitial pneumonia (NSIP) (31.9%) and others (27.8%). ABA was prescribed at standard dose, i.v. (25.5%) or s.c. (74.5%). After a median follow-up of 12 (6–36) months the following variables did not show worsening: dyspnoea (MMRC) (91.9%); FVC (87.7%); DLCO (90.6%); and chest HRCT (76.6%). A significant improvement of DAS28ESR from 4.5 (1.5) to 3.1 (1.3) at the end of follow-up (P Conclusion ABA may be an effective and safe treatment for patients with RA-ILD.
- Published
- 2020