학술논문
Abatacept in interstitial lung disease associated with rheumatoid arthritis: national multicenter study of 263 patients.
Document Type
Article
Author
Fernández-Díaz, Carlos; Castañeda, Santos; Melero-González, Rafael B; Ortiz-Sanjuán, Francisco; Juan-Mas, Antonio; Carrasco-Cubero, Carmen; Casafont-Solé, Ivette; Olivé, Alejandro; Rodríguez-Muguruza, Samantha; Almodóvar-González, Raquel; Castellanos-Moreira, Raul; Rodríguez-García, Sebastian C; Aguilera-Cros, Clara; Villa, Ignacio; Ordóñez-Palau, Sergio; Raya-Alvarez, Erique; Morales-Garrido, Pilar; Ojeda-García, Clara; Moreno-Ramos, Manuel J; Hernán, María Gema Bonilla
Source
Subject
*RHEUMATOID arthritis diagnosis
*INTERSTITIAL lung diseases
*MEDICAL cooperation
*RESEARCH
*RHEUMATOID arthritis
*STATISTICS
*DATA analysis
*TREATMENT effectiveness
*DATA analysis software
*ABATACEPT
*DESCRIPTIVE statistics
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Language
ISSN
1462-0324
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 < 0.001) and a CS-sparing effect from a median 7.5 (5–10) to 5 (2.5–7.5) mg/day at the end of follow-up (P < 0.001) was also observed. ABA was withdrawn in 62 (23.6%) patients due to adverse events (n = 30), articular inefficacy (n = 27), ILD worsening (n = 3) and other causes (n = 2). Conclusion ABA may be an effective and safe treatment for patients with RA-ILD. [ABSTRACT FROM AUTHOR]