Poster Session C
Rheumatoid arthritis (RA)
Ana Serrano-Combarro, MD
Hospital Universitario Marqués de Valdecilla, IDIVAL
Santander, Cantabria, Spain
No financial relationships with ineligible companies to disclose
A total of 74 patients (31 women/43 men) were collected, mean age of 69.3±8.8 years. Median ILD duration up to antifibrotic initiation was 51 [22-77.5] months. NINTE was administered in combination with corticosteroids (n=54), cDMARD (n=21), bDMARD (n=46) and/or JAKi (n=4). Mean FVC one year before NINTE start was 81.9±21.2 (% pred.), whilst mean baseline FVC was 73.7±22.5 (% pred.). After a median follow-up of 15 [4-23] months, no significant decline in mean FVC or DLCO values was observed (Figure 1). In the intra-individual analysis (Table 1), the absolute change in FVC at 12 months from baseline was of 1.04±2.18 % and -25.61±70.47 ml. In addition, the absolute change in FVC (ml) at 18 and 24 months from baseline turned into positive (17.06±82.79 and 36.00±221.51 ml, respectively). Gastrointestinal adverse events were the most common reason for NINTE discontinuation. The retention rate was 78.4% (58 patients) at the end of follow-up. In contrast with the INBUILD trial, RA-ILD patients from clinical practice were older, had a higher tobacco exposure, time since ILD diagnosis was longer and treatment with combined immunosuppressants was more frequent (Table 2). However, baseline mean values of FVC and DLCO were similar in both groups.
Conclusion:
NINTE seems to slow ILD progression in patients with RA-ILD. In clinical practice, patients are treated later in the evolution of the disease, but results are satisfactory. Combination of NINTE and DMARDs in RA-ILD is possible and safe.
Table 1. Comparison of intra-individual mean absolute change of FVC (in ml and %) between two time points in RA-ILD patients treated with NINTE in clinical practice.
Figure 1. Evolution of FVC and DLCO in 74 patients with RA-ILD treated with NINTE in clinical practice since the two previous years of initiation.
Table 2. Comparison of baseline characteristics of RA-ILD patients treated with NINTE in clinical practice and RA-ILD patients included in the INBUILD trial.
*Patients from de INBUILD trial were restricted to use at baseline: glucocorticoids if >20 mg/day prednisone or equivalent, mycophenolate mofetil, cyclophosphamide, cyclosporine, tacrolimus, azathioprine and rituximab.
ACPA, anti-citrullinated protein antibodies; DLCO, diffusing capacity of the lung for carbon monoxide; DMARD, disease-modifying antirheumatic drug; FVC, forced vital capacity; HRCT, high-resolution computed tomography; ILD, interstitial lung disease; IQR, interquartile range; JAKi, JAK inhibitor; mMRC: modified Medical Research Council scale; NINTE, nintedanib; PCB, placebo; RA, rheumatoid arthritis; RF, rheumatoid factor; SD, standard deviation; UIP, usual interstitial pneumonia.
B. Atienza-Mateo: None; A. Serrano-Combarro: None; J. Loarce: None; N. Vegas Revenga: None; M. Martín López: 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. Melero-Gonzalez: None; N. Mena Vázquez: None; C. Carrasco-Cubero: None; C. Díez Morrondo: None; D. Castro-Corredor: None; T. Vázquez Rodríguez: None; A. García-Valle: None; G. Bonilla: None; M. Rodriguez: None; I. Brana Abascal: None; S. Rojas Herrera: None; J. Sarmiento-Monroy: None; P. Andújar-Brazal: None; 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.