Hospital Universitario Marqués de Valdecilla, IDIVAL Santander, Cantabria, Spain
No financial relationships with ineligible companies to disclose
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, Lucia Cristina Dominguez Casas11, Cilia Peralta Ginés12, Carolina Diez Morrondo13, 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, Mireia Moreno Martinez-Losa23, Ana Urruticoechea-Arana24, Sergi Ordoñez25, Carmen González Montagut26, Andrea García-Valle27, Juan Ramón De Dios28, Patricia Carreira29, Tomás Vázquez Rodríguez30, Delia Fernández-Lozano31, Ignacio Brana Abascal32, Rafael Benito Melero-Gonzalez33, Emilio Giner34, Virginia Ruiz Esquide35, Clara Ventin Rodriguez36, Marina Rodriguez37, Pablo Andújar-Brazal38, Julia Fernandez Melon39, Lilian M. López-Núñez40, JOSE RAMON LAMUA RIAZUELO41, Carlos Fernández Díaz42, Javier Loricera43 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 Universtario San Agustin, Oviedo, Spain, 12Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, 13Hospital de Leon, León, 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, 203Hospital Universitario de Donosti, San Sebastian, Spain, San Sebastian, Pais Vasco, Spain, 21Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain, 22Hospital de Sagunto, Valencia, Spain, 23Parc Tauli Hospital Universitari, I3PT(UAB), Barcelona, Spain, 24Hospital Son Espases, Palma de Mallorca, Islas Baleares, Spain, 25Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain, 26Hospital Universitario de Valladolid, Valladolid, Spain, 27Hospital General Río Carrión, Palencia, Spain, 28Osakidetza, Vitoria, Spain, 29Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain, 30Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain, 31Hospital Clínico Universitario de Valencia, Valencia, Spain, 32Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain, 33CHU Ourense, O Carballino, Spain, 34Hospital Royo Villanova, Teruel, Spain, 35Hospital Clinic Barcelona, Barcelona, Spain, 36Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain, 37Hospital Clínico Universitario de Santiago, La Coruna, Spain, 38Hospital Universitario Doctor Peset, Valencia, Spain, 39Hospital Son Espases, Palma, Spain, 40Hospital Universitari Son Llàtzer, Palma, Spain, 41Hospital Universitario del Henares, Madrid, Spain, 42Hospital Universitario Santa Lucía, Cartagena, Spain, 43Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 44Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain Background/Purpose: Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). Abatacept (ABA) has demonstrated effectiveness in the treatment of RA-ILD, regardless combined or not with methotrexate and the radiological pattern. Although global results are satisfactory, there are patients who present progression of ILD despite its use. The characterization of this group of patients is crucial for its early identification and management. Our objective is to assess a) the RA-ILD patients treated with ABA with progression of ILD and b) comparative study with patients without progression.
Methods: From a large observational multicenter study of 526 RA-ILD patients treated with ABA, we selected those with available pulmonary function tests (PFTs) follow-up data. Progression of ILD was defined as an absolute decline of forced vital capacity (FVC) of ≥10% within 2 years of follow-up since ABA initiation (Figure). compared demographic and clinical variables of patients with ILD progression vs. patients with ILD improvement or stabilization. Results are expressed as percentage, mean±SD or median [IQR].
Results: We included a total of 343 patients with available data on FVC evolution, of which 80 (23.3%) presented ILD progression and 263 (76.7%) had a favorable lung function course. The differential baseline demographic and clinical characteristics between these 2 groups of patients are displayed in Table. We found no statistically significant differences between both groups in terms of age, sex, smoking, ILD duration up to ABA initiation, positivity of rheumatoid factor or anti-citrullinated protein autoantibodies, combined treatment, prednisone dose, baseline PFTs or radiological pattern. The differences in basal dyspnea and previous therapy with methotrexate and tocilizumab were statistically significant.
Conclusion: Almost a quarter of patients with ABA therapy presented ILD progression. There were few differences between progressive group and non-progressive group. Although ABA has consistently demonstrated effectiveness in the treatment of RA-ILD, its response should be closely monitored in all the patients to early detect progression.
Table. Comparison of main baseline features of RA-ILD patients treated with ABA divided into ILD progression and no-ILD progression groups.
Figure. Evolution of FVC in patients included in “ILD progression” group vs in those included in “no ILD progression” (progression of ILD was defined as an absolute decline of forced vital capacity (FVC) of ≥10% within 2 years of follow-up since ABA initiation). * p <0,05
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. Dominguez Casas: None; C. Peralta Ginés: None; C. Diez Morrondo: 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; M. Moreno Martinez-Losa: None; A. Urruticoechea-Arana: None; S. Ordoñez: None; C. González Montagut: None; A. García-Valle: None; J. De Dios: None; P. Carreira: 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; 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; 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.