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 ABA was withdrawn in 62 (23.6%) patients due to adverse events (n = 30), articular inefficacy (n = 27), ILD worsening (n = 3) and other causes (n = 2).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.
Introduction: The aim of this study is to assess the relationship among inflammatory charge, cardiovascular risk and bone metabolism in patients with rheumatoid arthritis initiating biological therapy treatment. Patients and methods: This is a prospective cohort study conducted in patients diagnosed with active rheumatoid arthritis (RA) assessed in the Rheumatology Unit and initiating biological therapy. Patients will be selected consecutively, with preliminary data on 14 patients. We present preliminary data from 14 patients. Results: Reduced Dickkopf-1 (DKK1) concentrations after commencing biological therapy were detected (baseline: 53.12±60.43 pg/ml vs 6 months 13.5±23.2 pg/ml, p=0.307) but without statistical significance. Changes were found in markers for bone remodeling with increased osteocalcin levels and CTX which were not statistically significant either. Conclusions: We observed a nonsignificant decrease in DKK1 serum in patients with active RA treated with biologic therapy. Expanding the scope of study subjects and pending biochemical determinations will allow us, in the near future, to establish more precisely this link and the relationship of DKK1, bone remodeling, biological therapy and cardiovascular disease in RA patients.
Background The antimalarial drugs are considered safe and well tolerated, with minimal risk of side effects. Hydroxychloroquine is considered safer but less effective than chloroquine, although the choice remains a matter of debate and is generally dependent on the experience. Both can cause ocular toxicity corneal and retinal deposition. The latter produces irreversible alterations of the vision and the patient may not perceive his presence at an early stage so regular eye tests are recommended Objectives To study the incidence of retinal toxicity in patients treated with antimalarials in a Rheumatology consultation. Methods We conducted a retrospective study of 39 patients treated with antimalarials in rheumatology consultation who were referred to ophthalmology to study retinal toxicity during 2011. Data collection included demographic data of patients, type of antimalarial prescribed, daily and cumulative doses, base rheumatic disease, corticosteroid use, associated morbidity and ophthalmological examination. Results Five out of 39 patients had alterations in the SD-OCT, and two out of these five were also observed in the funduscopy. Among the patients with retinopathy, three had been treated with chloroquine (CQ) and two with hydroxychloroquine (HCQ). The average duration of treatment in these patients was 2.37±1.37 years and the mean cumulative dose of CQ was 559 g and 172.5 g for HCQ. There is no statistically significant association between retinal toxicity and sex, age, rheumatic disease, duration or dose of treatment with p value greater than 0.05. Conclusions The incidence of retinal toxicity in our patients treated with antimalarial drugs was 12.8%. Chloroquine was the antimalarial that caused most of cases of retinopathy and the most sensitive test to detect it was the SD-OCT. References Peponis V, Kyttaris VC, Chalkiadakis SE, Bonovas S, Sitaras NM. Ocular side effects of antirheumatic medications: what a rheumatologist should know. Lupus. 2010;19(6): 675-682 Wolfe F, Marmor MF. Rates and predictors of hydroxochloroquine retinal toxicity in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2010;62(6): 775-84 Levy GD, Munz SJ, Pachal J, Cohen HB, Pince KJ, Peterson T. Incidence of hydroxychloroquine retinopathy in 1207 patients in a large multicenter outpatient practice. Arthritis Rheum 1997; 40: 1482-6. Kobak S, Deveci H. Retinopathy due to antimalarial drugs in patients with connective tissue diseases: are they so innocent? A single center retrospective study. Int J Rheum Dis. 2010 Aug;13(3):e11-5. Marmor MF, Kellner U, Lai TY, Lyons JS, Mieler WF. Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology. 2011 Feb;118(2):415-22 Disclosure of Interest None Declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.