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Multicenter Study
. 2024 Jan:119:118-124.
doi: 10.1016/j.ejim.2023.08.025. Epub 2023 Sep 4.

Abatacept in usual and in non-specific interstitial pneumonia associated with rheumatoid arthritis

Belén Atienza-Mateo  1 , Carlos Fernández-Díaz  2 , Esther F Vicente-Rabaneda  3 , Rafael B Melero-González  4 , Francisco Ortiz-Sanjuán  5 , Ivette Casafont-Solé  6 , Sebastián C Rodríguez-García  7 , Iván Ferraz-Amaro  8 , Santos Castañeda  9 , Ricardo Blanco  10 ; Spanish Collaborative Group of Abatacept in Interstitial Lung Disease Associated with Rheumatoid Arthritis
Affiliations
Multicenter Study

Abatacept in usual and in non-specific interstitial pneumonia associated with rheumatoid arthritis

Belén Atienza-Mateo et al. Eur J Intern Med. 2024 Jan.

Abstract

Objective: To compare the effectiveness of abatacept (ABA) in Rheumatoid Arthritis-associated Interstitial Lung Disease (RA-ILD) according to the radiological patterns of usual (UIP) or non-specific interstitial pneumonia (NSIP).

Methods: From an observational longitudinal multicentre study of 263 RA-ILD patients treated with ABA, those with UIP or NSIP were selected. Lung function, chest high resolution computerised tomography (HRCT) and dyspnoea were recorded and compared in both groups from baseline to the end of follow-up (progression definitions: improvement or worsening >10% of FVC or DLCO, changes in HRCT extension and 1-point change in the mMRC scale, respectively). Differences between final and baseline visits were calculated as the average difference (95% CI) through mixed effects models regression.

Results: We studied 190 patients with UIP (n=106) and NSIP (n=84). General features were similar in both groups except for older age, positive rheumatoid factor, and previous sulfasalazine therapy, which were more frequent in patients with UIP. ILD duration up to ABA initiation was relatively short: median 16 [4-50] and 11 [2-36] months (p=0.36) in UIP and NSIP, respectively. Mean baseline FVC and DLCO were 82% and 63% in UIP and 89% and 65% in NSIP, respectively. Both parameters remained stable during 24 months with ABA. HRCT lesions and dyspnoea improved/stabilized in 73.1% and 90.5% and 72.9% and 94.6% of UIP and NSIP patterns, respectively.

Conclusion: ABA seems equally effective in stabilizing dyspnoea, lung function and radiological impairment in both UIP and NSIP patterns of RA-ILD. Early administration of ABA may prevent RA-ILD progression, regardless of the radiological pattern.

Keywords: Abatacept; Interstitial lung disease; Non-specific interstitial pneumonia; Rheumatoid arthritis; Usual interstitial pneumonia.

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Conflict of interest statement

Declaration of Competing Interest Disclosures that may be interpreted as constituting of possible conflict(s) of interest for the study:B. A.-M. received grants/research supports from Abbvie and Roche and had consultation fees/participation in company-sponsored speaker´s bureau from Pfizer, Celgene, Novartis, Sanofi, Janssen, UCB and Lilly, outside the submitted work; C.F.-D. has received fees in company-sponsored speaker's bureau from: Janssen, Galápagos, Amgen, Bristol Myers Squibb (BMS); E.F.V.-R .has received research supports and had consultation fees/participation in company-sponsored speaker's bureau from BMS; S.C.R.-G. reports financial support from the Hospital Clinic of Barcelona, Research, Innovation and Education Department (Grant # 32_ 251204_PFR_2018) and the Spanish Rheumatology Foundation (“Grants for physician-researchers 2018- 2021”). Personal fees from Roche, Sanofi, MSD, UCB-Pharma, Bristol-Myers-Squibb, Galápagos, Janssen, and Novartis, and non-financial support from Lilly, Pfizer, Sanofi, MSD, Abbvie, UCB-Pharma, outside the submitted work; I. F.-A. has received grants/research supports from Abbott, MSD, Janssen, and Roche, as well as consultation fees from company sponsored speakers bureaus associated with Abbott, Pfizer, Roche, Sanofi, Celgene, and MSD; S.C. has received research supports from MSD and Pfizer and had consultation fees/participation in company-sponsored speaker's bureau from Amgen, BMS, Eli-Lilly, MSD, Roche, and UCB. S. C. is also assistant professor of the cátedra EPID-Future, funded by UAM-Roche, Universidad Autónoma de Madrid (UAM), Spain; R. B. received grants/research supports from Abbvie, MSD, lilly and Roche, and had consultation fees/participation in company-sponsored speaker's bureau from Abbvie, Lilly, Pfizer, Roche, BMS, Janssen and MSD. The rest of authors have declared no conflicts of interest.

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